AUTHOR=Wireko Solomon , Asiedu Samuel Opoku , Kini Priscilla , Aglomasa Bill Clinton , Amewu Emmanuel Kobla Atsu , Asiedu Ebenezer , Osei-Akoto Freda , Boahen Kennedy Gyau , Obiri-Yeboah Dorcas , Amato Katherine Ryan , Kwarteng Alexander 

TITLE=Prevalence of Methicillin-Resistant Staphylococcus Species Among Filarial Lymphedema Patients in Ahanta West District of Ghana

JOURNAL=Frontiers in Tropical Diseases

VOLUME=2

YEAR=2021

URL=https://www.frontiersin.org/journals/tropical-diseases/articles/10.3389/fitd.2021.786378

DOI=10.3389/fitd.2021.786378

ISSN=2673-7515

ABSTRACT=<sec><title>Background</title><p>Filarial pathologies such as lymphedema may be associated with complications such as chronic non-healing wounds. Nonetheless, the role of bacterial population colonizing the lymphedematous legs has been posited to worsen the conditions of those living with the infection. These bacteria are usually composed of staphylococcal species partly because they are commensals. Thus, this present study sought to type the methicillin-resistant <italic>Staphylococcus aureus</italic> (MRSA) prevalence among individuals presenting with filarial lymphedema, particularly as MRSA tends to affect treatments options.</p></sec><sec><title>Methods</title><p>We recruited individuals (<italic>n</italic> = 321) with stages I–VII of lymphedema in a cross-sectional study in the Ahanta West district of the Western Region of Ghana. Swabs from lymphedematous limb ulcers, pus, and cutaneous surfaces were cultured using standard culture-based techniques. The culture isolates were later identified using Matrix-assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) mass spectrometry.</p></sec><sec><title>Results</title><p>A total of 192 <italic>Staphylococci</italic> species were isolated, with an overall prevalence of 39.7% (95% CI: 35%–44%; N = 483). <italic>S. hominis</italic> was the most prevalent species (23.95%), followed by <italic>S. haemolyticus</italic> (20.83%), <italic>S. epidermidis</italic> (15.10%), <italic>S. aureus</italic> (10.41%), and <italic>S. saprophyticus</italic> (9.32%). The remaining 20.34% were distributed among <italic>S. wanneri</italic>, <italic>S. sciuri</italic>, <italic>S. pasteuri</italic>, <italic>S. xylosus</italic>, <italic>S. simulans</italic>, <italic>S. cohnii</italic>, <italic>S. caprae</italic>, <italic>S. lugdunensis</italic>, and <italic>S. capitis</italic>. MRSA, containing <italic>mecA</italic> gene, was detected in 21 out of 31 <italic>Staphylococci</italic> isolates tested, with an overall prevalence of 68% (95% CI: 51%–84%). In addition, a virulent gene, Panton–Valentine leukocidin (<italic>PVL</italic>), which is usually associated with <italic>S. aureus</italic>, was detected in 20/31 (64.5%) <italic>S. aureus</italic> in the study.</p></sec><sec><title>Conclusion</title><p>These results suggest that MRSA species may pose a challenge to the treatment of filarial lymphedema with antibiotics particularly, as doxycycline is currently being piloted in some endemic areas to treat the infection. Thus, intensive antimicrobial resistance surveillance should be conducted in endemic areas by health authorities to forestall the dilemma of multidrug resistance not only against lymphatic filariasis (LF) infection but other diseases.</p></sec>