AUTHOR=Vubil Delfino , Garrine Marcelino , Ruffing Ulla , Acácio Sozinho , Sigaúque Betuel , Alonso Pedro L. , von Müller Lutz , Herrmann Mathias , Mandomando Inácio 

TITLE=Molecular Characterization of Community Acquired Staphylococcus aureus Bacteremia in Young Children in Southern Mozambique, 2001–2009

JOURNAL=Frontiers in Microbiology

VOLUME=8

YEAR=2017

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2017.00730

DOI=10.3389/fmicb.2017.00730

ISSN=1664-302X

ABSTRACT=<p><bold>Background:</bold> The emergence of community-acquired <italic>Staphylococcus aureus</italic> infections is increasingly recognized as life threating problem worldwide. In Manhiça district, southern Mozambique, <italic>S. aureus</italic> is the leading cause of community-acquired bacteremia in neonates.</p><p><bold>Methods:</bold> Eighty-four <italic>S. aureus</italic> isolates from children less than 5 years admitted to Manhiça District Hospital from 2001 to 2009 were randomly selected and genetically characterized by DNA microarray and <italic>spa</italic> typing. Antimicrobial susceptibility was determined by VITEK 2.</p><p><bold>Results:</bold> Thirty-eight different <italic>spa</italic> types and 14 clonal complexes (CC) were identified. <italic>Spa</italic>-type t084 (<italic>n</italic> = 10; 12%) was the most predominant while CC8 (<italic>n</italic> = 18; 21%) and CC15 (<italic>n</italic> = 14; 16%) were the most frequent CCs. Mortality tended to be higher among children infected with CC45 (33.3%, 1/3) and CC8 (27.8%, 5/18). The majority of isolates possessed the accessory gene regulator I (45%) and belonged to either capsule type 8 (52%) or 5 (47%). Panton valentine leukocidin (PVL) encoding genes were detected in 30%. Antibiotic resistance was high for penicillin (89%), tetracycline (59%) and Trimethoprim Sulfamethoxazole (36%) while MRSA was uncommon (8%).</p><p><bold>Conclusions:</bold> Although MRSA were uncommon, we found high genetic diversity of methicillin susceptible <italic>S. aureus</italic> causing bacteremia in Mozambican children, associated with high resistance to the most available antibiotics in this community. Some CCs are likely to be more lethal indicating the need for prompt recognition and appropriate treatment.</p>