Origins and spread of methicillin-resistant staphylococcus aureus in greater Kabale region - South western Uganda

Abstract

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) remains a major global healthcare problem responsible for increased motility, prolonged hospitalization and surging economic loss in the livestock. The prevalence in human across African continent is heterogeneous. The emergency of highly pathogenic clones is of solemn concern. We determined the nasopharyngeal carriage rate of MRSA, respective spa diversity and relatedness among human and livestock from greater Kabale region — south western Uganda. Materials and methods: This was a cross-sectional study, carried out in greater Kabale region, between June 2016 and April, 2019. Nasopharyngeal samples from 580 outpatients and 450 routine clinical samples were processed for identification of MRSA basing on inhibition zone diameter of f19mm on 30 ug cefoxitin disk and MecA PCR. The positive MRSA outpatients were followed back to their respective house hold contacts (n = 1536) and domestic cattle (n = 710) and swine (n = 585) swabbed and their nasopharyngeal swabs also analysed for presence of MRSA. "The spa typing was performed using PCR — High resolution melting based method. The spa sequences analysed using MEGA — X software to determine phylogenetic relationship. Results: A total of 487 MRSA isolates (18.9%) were recovered from human (OPD, HHC and IP) while 342 MRSA isolates (26.4%) were recovered from cattle and swine. A total 27 spa types were recovered among all isolates which included Spa types; t701, t034, 041, 1044, t437, t037, t4677, t127 t1451, 19377, t032, t121, t1544, t922, 019, t108, t002, t030, t018, 002, t040, t021, t012, t! 358, t267 and 025 were detected and the most frequent were and 11451 (6.9%). spa types; t021, t012, t1358 and t325 were only recovered from inpatients. Conclusion: MRSA carriage rate in both human and animal of greater Kabale region is high with increasing spa types diversity. The origin of spread remains unknown but there are ongoing bidirectional transmissions between humans and animals. Infection prevention and control procedures in both community, human health-care settings and animal husbandry is urgently needed to restrict infections using one health approached.