Nasal carriage of virulent and multidrug resistant Staphylococcus aureus: a possible comorbidity of COVID-19.

BACKGROUND: Staphylococcus aureus (S. aureus) associated with COVID-19 has not been well documented. This cross-sectional study evaluated the association between nasal S. aureus carriage and COVID-19. METHODS AND RESULTS: Nasopharyngeal samples were collected from 391 participants presenting for COVID-19 test in Lagos, Nigeria, and S. aureus was isolated from the samples. Antimicrobial susceptibility test was done by disc diffusion method. All S. aureus isolates were screened for the presence of mecA, panton-valentine leucocidin (PVL) and toxic shock syndrome toxin (TSST) virulence genes by polymerase chain reaction. Staphylococcal protein A (spa) typing was conducted for all the isolates. Participants with COVID-19 had double the prevalence of S. aureus (42.86%) compared to those who tested negative (20.54%). A significant association was seen between S. aureus nasal carriage and COVID-19 (p = 0.004). Antimicrobial sensitivity results showed resistance to oxacillin (100%), cefoxitin (53%), and vancomycin (98.7%). However, only 41% of the isolates harbored the mecA gene, with SCCmecV being the most common SCCmec type. There was no association between the carriage of virulence genes and COVID-19. A total of 23 Spa types were detected, with t13249 and t095 being the two most common spa types. CONCLUSION: This study examined the association between nasal S. aureus carriage and SARS-COV-2 infection. Further research is required to fully explore the implications of S. aureus co-infection with COVID-19.

Multidrug-Resistant Kocuria rosea and Methicillin-Resistant Staphylococcus aureus Co-Infection in a Nigerian Patient with COVID-19: A Case Report.

BACKGROUND Bacterial Infections, especially, of the respiratory system, have been reported as one of the medical concerns in patients with the Coronavirus Disease-2019 (COVID-19), particularly those with multiple co-morbidities. We present a case of a diabetic patient with co-infection of multi-drug-resistant Kocuria rosea and methicillin-resistant Staphylococcus aureus (MRSA) who contracted COVID-19. CASE REPORT A 72-year-old man with diabetes presented with symptoms including cough, chest pain, urinary incontinence, respiratory distress, sore throat, fever, diarrhea, loss of taste, and anosmia and was confirmed to have COVID-19. At admission, he was also found to have sepsis. MRSA was isolated in conjunction with another organism, resembling coagulase-negative Staphylococcus, which was misidentified using commercial biochemical testing systems. The strain was finally confirmed to be Kocuria rosea by 16S rRNA gene sequencing. Both strains were highly resistant to multiple classes of antibiotics, but the Kocuria rosea was resistant to all the cephalosporins, fluoroquinolones, and macrolides tested. The use of ceftriaxone and ciprofloxacin did not improve his condition, which ultimately led to his death. CONCLUSIONS This case report shows that the presence of multi-drug-resistant bacteria infections can be fatal in patients with COVID-19, especially in patients with other co-morbidities like diabetes. This case report also shows that biochemical testing may be inadequate in identifying emerging bacterial infections and there is a need to include proper bacterial screening and treatment in the management of COVID-19, especially in patients with other co-morbidities and with indwelling devices.

Assessment of well water as a reservoir for extended-spectrum ß-lactamases (ESBL) and carbapenem resistant Enterobacteriaceae from Iwo, Osun state, Nigeria.

Background and Objectives: Unsafe water supplies are of public health concern, especially in developing countries. This article aims to investigate the microbiological quality of water from eight Wells in Iwo and to explore for the extended-spectrum ß-lactamase (ESBL) and carbapenemase genes contained in isolated enteric bacteria from in the water samples. Materials and Methods: Bacterial isolation and identification were done using standard conventional methods. Antibiotic susceptibility testing was conducted using the Kirby-Bauer method. Ten phenotypically carbapenem-resistant isolates were further subjected to genotypic analysis (PCR amplification) for the detection of ESBL and carbapenemase gene. Results: A total of 148 Enterobacteriaceae isolates belonging to seven (7) genera were isolated and identified which included E. coli, Enterobacter spp., Klebsiella spp., Salmonella, Citrobacter sp, Proteus, and Shigella. Results showed that 55% of isolates were resistant to tetracycline, 28% to cefepime, the least resistance was shown in moxifloxacin and gentamicin which had 6% and 9%, respectively, of the total isolates. For the two carbapenems used, results showed meropenem and imipenem had resistant values of 14% each, respectively. Two isolates carried the bla CTX-M gene while the carbapenemase gene (bla KPC, bla NDM, and bla OXA) was not detected in all the ten isolates. Conclusion: There was also negative chromosomal detection of carbapenemase in MDR isolates from well waters in Iwo town. Consequently, resistance to carbapenem antibiotics in these isolates may not be mediated by carbapenemase but by the production of extended-spectrum ß-lactamases and through other mechanisms of resistance.