Characterisation of Staphylococcus aureus isolates from bloodstream infections, Democratic Republic of the Congo.

Staphylococcus aureus is known worldwide as an invasive pathogen, but information on S. aureus from bloodstream infections in Central Africa remains scarce. A collection of S. aureus blood culture isolates recovered from hospitals in four provinces in the Democratic Republic of the Congo (2009-2013) was assessed. A total of 27/108 isolates were methicillin-resistant S. aureus (MRSA), of which >70% were co-resistant to aminoglycosides, tetracyclines, macrolides and lincosamides. For MRSA and methicillin-susceptible S. aureus (MSSA) isolates, resistance to chloramphenicol and trimethoprim-sulphamethoxazole (TMP-SMX) was <10%. However, 66.7% (72/108) of all isolates harboured the trimethoprim resistance gene dfrG. More than three-quarters (84/108, 77.8%) of isolates belonged to CC5, CC8, CC121 or CC152. Genetic diversity was higher among MSSA (31 spa types) compared to MRSA (four spa types). Most MRSA (23/27, 85.2%) belonged to CC8-spa t1476-SCCmec V and 17/23 (73.9%) MRSA ST8 were oxacillin susceptible but cefoxitin resistant. Among MRSA and MSSA combined, 49.1% (53/108) and 19.4% (21/108) contained the genes encoding for Panton-Valentine leucocidin (lukS-lukF PV, PVL) and toxic shock syndrome toxin-1 (tst, TSST-1), respectively. PVL was mainly detected among MSSA (51/53 isolates harbouring PVL were MSSA, 96.2%) and associated with CC121, CC152, CC1 and CC5. TSST-1 was associated with CC8-spa t1476-SCCmec V. The immune evasion cluster (IEC) genes scn, sak and chp were detected in 81.5% of isolates (88/108, equally represented among MSSA and MRSA). The present study confirms the occurrence of MRSA with high levels of multidrug co-resistance and PVL-positive MSSA among invasive S. aureus isolates in Central Africa.

Déterminants de la réponse à l'intradermoréaction à la tuberculine à Kisangani, RDC

Introduction: Le diagnostic de la primo-infection tuberculeuse de l'enfant est difficile en situation de ressources limitées et c'est généralement à la tuberculine qu'on a recours. Le but de cette étude est de déterminer les facteurs qui peuvent influencer la réponse positive de l'intradermoréaction à la tuberculine en situation d'endémie Matériel et Méthode: Etude transversale analytique réalisée à Kisangani du 05 mars 2012 au 27 décembre 2013 chez 593 enfants d'âge compris entre 6 mois et 15 ans suivis au «Village de Pédiatrie». Chacun a subi l'intradermoréaction à la tuberculine et la lecture était faite 72 heures après. Le Chi-carré de tendance et le Test exact de Ficher, où c'est approprié, ont été utilisés Résultat: A Kisangani, le taux de prévalence de l'intradermoréaction positive (IDR+) s'élève à 31,53%. Il est identique dans les deux sexes. Celui-ci décroit significativement avec l'âge (p<0,0002): 38,0% entre 6 et 11mois, 26,4% entre 12 et 24mois, 21,4% entre 6 et 10ans puis remonte à partir de 11ans (47,0%). La positivité de l'IDR augmente avec la notion de BCG dans 69,7% de cas (p<0,0017) et avec la notion de contage tuberculeux (p<0,006) Conclusion: A Kisangani, le taux de prévalence de l'intradermoréaction positive est similaire à celui décrit en situation d'endémie. Le taux de positivité décroit avec l'âge. La cicatrice BCG et la notion de contage augmentent la positivité de l'IDR+

Staphylococcus aureus nasal carriage among healthcare workers in Kisangani, the Democratic Republic of the Congo.

Methicillin-resistant Staphylococcus aureus (MRSA) is a global health concern, but there are few data from Central Africa. The objective of our study was to characterise S. aureus colonisation isolates from healthcare-exposed professionals in the Democratic Republic of the Congo (DRC). Healthcare workers and medical students (n = 380) in Kisangani, DRC were screened for S. aureus nasal carriage in a single-centre cross-sectional study in the University Hospital of Kisangani. The isolates were identified and characterised using phenotypic and genotypic methods. The nasal carriage rate of S. aureus was 16.6 % and 10 out of 63 isolates (15.9 %) were MRSA. We found 28 different spa types. Most MRSA isolates belonged to ST8-spa t1476-SCCmec V. The majority of MRSA were multidrug-resistant to non-beta-lactam antibiotics. Overall, 28.5 % of S. aureus carried Panton-Valentine leucocidin (PVL)-encoding genes (all methicillin-sensitive) and 17.5 % carried toxic shock syndrome toxin-1 (TSST-1)-encoding genes. The finding of MRSA carriage among healthcare workers in a setting with limited access to diagnostic microbiology and appropriate therapy calls for improved education on infection control practices and supports the introduction of surveillance programmes.