Epidemiology of methicillin-susceptible Staphylococcus aureus lineages in five major African towns: high prevalence of Panton-Valentine leukocidin genes.

Breurec S, Fall C, Pouillot R, Boisier P, Brisse S, Diene-Sarr F, Djibo S, Etienne J, Fonkoua MC, Perrier-Gros-Claude JD, Ramarokoto CE, Randrianirina F, Thiberge JM, Zriouil SB; the Working Group on Staphylococcus aureus infections, Garin B, Laurent F.

Abstract The epidemiology of methicillin-susceptible Staphylococcus aureus (MSSA) in Africa is poorly documented. From January 2007 to March 2008, 555 S. aureus strains were collected from five African towns in Cameroon, Madagascar, Morocco, Niger and Senegal, of which 456 unique isolates were susceptible to methicillin. Around 50% of the MSSA isolates from each different participating center were randomly selected for further molecular analysis. Of the 228 isolates investigated, 132 (58%) belonged to 5 major multilocus sequence typing clonal complexes (MLST CC1, CC15, CC30, CC121, and CC152) that were not related to any successful methicillin-resistant S. aureus (MRSA) clones previously identified in the same study population. The luk-PV genes encoding the Panton-Valentine leukocidin (PVL), present in 130 isolates overall (57%), were highly prevalent in strains from Cameroon, Niger, and Senegal (West and Central Africa). This finding is of major concern, both as a source of severe infections and as a potential reservoir for PVL genes. This overrepresentation of PVL in MSSA could lead to the emergence and spread of successful highly virulent PVL-positive MRSA clones, a phenomenon that has already started in Africa.

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