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Prevalence and molecular characteristics of methicillin-resistant Staphylococcus aureus among skin and soft tissue infections in an emergency department in Guyana
  1. Adeline Dozois1,
  2. Isaac Thomsen2,
  3. Natalia Jimenez-Truque2,
  4. Nicole Soper3,
  5. Alexis Pearson3,
  6. Pheona Mohamed-Rambaran3,
  7. Kristen B Dettorre4,
  8. C Buddy Creech2,
  9. Seth W Wright4
  1. 1Vanderbilt University School of Medicine, Nashville, Tennessee, USA
  2. 2Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University, Nashville, Tennessee, USA
  3. 3Department of Laboratory Services, Georgetown Public Hospital Corporation, Georgetown, Guyana
  4. 4Division of International Health, Department of Emergency Medicine, Vanderbilt University, Nashville, Tennessee, USA
  1. Correspondence to Adeline Dozois, Vanderbilt University School of Medicine, 2137 Fairfax Ave #13, Nashville, TN 37212, USA; adeline.dozois{at}gmail.com

Abstract

Objective The characteristics of staphylococcal skin and soft tissue infections (SSTIs) are poorly understood in northern South America and the Caribbean. The objectives of this study were to determine the frequency of methicillin resistance among Staphylococcus aureus isolates in an emergency department (ED) in Guyana and to identify specific molecular characteristics of these methicillin-resistant Staphylococcus aureus (MRSA) strains.

Methods This was a cross-sectional study conducted at the main teaching hospital in Georgetown, Guyana. Eligible subjects included patients of all ages with SSTIs with obtainable purulent material. Purulent material was cultured, and S. aureus isolates were evaluated for antibiotic susceptibilities by disc diffusion. Molecular characterisation of MRSA isolates included identification of SCCmec type, assignment of genetic relatedness by rep-PCR and determination of the presence of two exotoxins, Panton-Valentine Leukocidin (PVL) and LukAB.

Results Eighty-five samples were collected; of these, 47 grew S. aureus. 24 of the 47 S. aureus samples were MRSA (51%; 95% CI 37% to 65%), representing 28% of all samples. All MRSA isolates were SCCmec type IV, PVL positive, LukAB positive and were highly related to the current epidemic clone in the USA, USA300.

Conclusions Here, we demonstrate a clinically significant proportion of methicillin resistance in SSTI-associated staphylococcal isolates. Guyanese isolates were highly related to the most common community-associated strain seen in the USA, USA300. These results have important implications for empiric antibiotic therapy and infection control policies in Guyana and similar settings.

  • infectious diseases, bacterial
  • soft tissue infection
  • local

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