Genetic Diversity of Staphylococcus aureus in Buruli Ulcer

Nana Ama Amissah*, Corinna Glasner, Anthony Ablordey, Caitlin S. Tetteh, Nana Konama Kotey, Isaac Prah, Tjip van der Werf, John W. Rossen, Jan Maarten van Dijl, Ymkje Stienstra

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

17 Citations (Scopus)
475 Downloads (Pure)

Abstract

Background

Buruli ulcer (BU) is a necrotizing skin disease caused by Mycobacterium ulcerans. Previous studies have shown that wounds of BU patients are colonized with M. ulcerans and several other microorganisms, including Staphylococcus aureus, which may interfere with wound healing. The present study was therefore aimed at investigating the diversity and topography of S. aureus colonizing BU patients during treatment.

Methodology

We investigated the presence, diversity, and spatio-temporal distribution of S. aureus in 30 confirmed BU patients from Ghana during treatment. S. aureus was isolated from nose and wound swabs, and by replica plating of wound dressings collected bi-weekly from patients. S. aureus isolates were characterized by multiple-locus variable number tandem repeat fingerprinting (MLVF) and spa-typing, and antibiotic susceptibility was tested.

Principal Findings

Nineteen (63%) of the 30 BU patients tested positive for S. aureus at least once during the sampling period, yielding 407 S. aureus isolates. Detailed analysis of 91 isolates grouped these isolates into 13 MLVF clusters and 13 spa-types. Five (26%) S. aureus-positive BU patients carried the same S. aureus genotype in their anterior nares and wounds. S. aureus isolates from the wounds of seven (37%) patients were distributed over two different MLVF clusters. Wounds of three (16%) patients were colonized with isolates belonging to two different genotypes at the same time, and five (26%) patients were colonized with different S. aureus types over time. Five (17%) of the 30 included BU patients tested positive for methicillin-resistant S. aureus (MRSA).

Conclusion/Significance

The present study showed that the wounds of many BU patients were contaminated with S. aureus, and that many BU patients from the different communities carried the same S. aureus genotype during treatment. This calls for improved wound care and hygiene.

Original languageEnglish
Article numbere0003421
Number of pages17
JournalPLoS Neglected Tropical Diseases
Volume9
Issue number2
DOIs
Publication statusPublished - Feb-2015

Keywords

  • MYCOBACTERIUM-ULCERANS
  • NASAL CARRIAGE
  • FUNCTIONAL LIMITATIONS
  • EPIDERMOLYSIS-BULLOSA
  • SKIN INFECTIONS
  • RESISTANT
  • STRAINS
  • COLONIZATION
  • DISEASE
  • TOXIN

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