Methicillin-resistant staphylococcus aureus in Melanesian children with haematogenous osteomyelitis from the Central Highlands of Papua New Guinea
- Aglua, Izzard, Jaworski, Jan, Drekore, Jimmy, Urakoko, Bohu, Poka, Harry, Michael, Audrey, Greenhill, Andrew
- Authors: Aglua, Izzard , Jaworski, Jan , Drekore, Jimmy , Urakoko, Bohu , Poka, Harry , Michael, Audrey , Greenhill, Andrew
- Date: 2018
- Type: Text , Journal article
- Relation: International Journal of Pediatrics Vol. 6, no. 10 (2018), p. 8361-8370
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- Description: Background: Methicillin-Resistant Staphylococcus aureus (MRSA) has been an important cause of bone infection since the 1940s. Current guidelines recommend targeted antibiotic use for osteomyelitis treatment informed by microbial sensitivity patterns. However, in settings without microbiology facilities, empirical antibiotic use is common. Unrecognized antibiotic resistance potentiates persistence of MRSA with osteomyelitis progression to chronic forms with complications despite antibiotic treatment. Materials and Methods: A prospective observational study was done to identify common etiological agent (s) in bone infection in Melanesian children (that were admitted to the two surgical and one pediatric wards of the SJNM-KUGH in the Simbu province of Papua New Guinea in 2012 and 2017), observe for presence of antimicrobial resistance, and determine effective antibiotic regimes for treatment of bone pediatric osteomyelitis. Seventy pediatric patients presenting from the community with osteomyelitis were recruited, with bone and non-bone specimens sampled, cultured and isolates tested for resistance to common antibiotics. Results: Staphylococcus aureus (S. aureus) was isolated in 67% (47/70) of collected specimens. Of the 47 isolates, there was 91.5% resistance to penicillin, 85.1% resistance to methicillin, 89.4% resistance to oxacillin, 93.6% resistance to ampicillin and 80.9% resistance to ceftriaxone. S. aureus showed 91.5% sensitivity to gentamycin, 93.6% sensitivity to erythromycin, tetracycline and clindamycin, and 95.7% sensitivity to Co-trimoxazole. Conclusion: MRSA was the leading cause of haematogenous osteomyelitis in Melanesian children. S.aureus was isolated mainly from infected long bones of the lower limbs (79%) of children presenting from the community, suggesting a predominantly community-associated MRSA.
- Authors: Aglua, Izzard , Jaworski, Jan , Drekore, Jimmy , Urakoko, Bohu , Poka, Harry , Michael, Audrey , Greenhill, Andrew
- Date: 2018
- Type: Text , Journal article
- Relation: International Journal of Pediatrics Vol. 6, no. 10 (2018), p. 8361-8370
- Full Text:
- Reviewed:
- Description: Background: Methicillin-Resistant Staphylococcus aureus (MRSA) has been an important cause of bone infection since the 1940s. Current guidelines recommend targeted antibiotic use for osteomyelitis treatment informed by microbial sensitivity patterns. However, in settings without microbiology facilities, empirical antibiotic use is common. Unrecognized antibiotic resistance potentiates persistence of MRSA with osteomyelitis progression to chronic forms with complications despite antibiotic treatment. Materials and Methods: A prospective observational study was done to identify common etiological agent (s) in bone infection in Melanesian children (that were admitted to the two surgical and one pediatric wards of the SJNM-KUGH in the Simbu province of Papua New Guinea in 2012 and 2017), observe for presence of antimicrobial resistance, and determine effective antibiotic regimes for treatment of bone pediatric osteomyelitis. Seventy pediatric patients presenting from the community with osteomyelitis were recruited, with bone and non-bone specimens sampled, cultured and isolates tested for resistance to common antibiotics. Results: Staphylococcus aureus (S. aureus) was isolated in 67% (47/70) of collected specimens. Of the 47 isolates, there was 91.5% resistance to penicillin, 85.1% resistance to methicillin, 89.4% resistance to oxacillin, 93.6% resistance to ampicillin and 80.9% resistance to ceftriaxone. S. aureus showed 91.5% sensitivity to gentamycin, 93.6% sensitivity to erythromycin, tetracycline and clindamycin, and 95.7% sensitivity to Co-trimoxazole. Conclusion: MRSA was the leading cause of haematogenous osteomyelitis in Melanesian children. S.aureus was isolated mainly from infected long bones of the lower limbs (79%) of children presenting from the community, suggesting a predominantly community-associated MRSA.
Phylodynamic signatures in the emergence of community-associated MRSA
- Steinig, Eike, Aglua, Izzard, Duchene, Sebastian, Meehan, Michael, Yoannes, Mition, Firth, Cadhla, Jaworski, Jan, Drekore, Jimmy, Urakoko, Bohu, Poka, Harry, Wurr, Clive, Ebos, Eri, Nangen, David, Müller, Elke, Mulvey, Peter, Jackson, Charlene, Blomfeldt, Anita, Aamot, Hege, Laman, Moses, Manning, Laurens, Earls, Megan, Coleman, David, Greenhill, Andrew, Ford, Rebecca, Stegger, Marc, Syed, Muhammad, Jamil, Bushra, Monecke, Stefan, Ehricht, Ralf, Smith, Simon, Pomat, William, Horwood, Paul, Tong, Steven, McBryde, Emma
- Authors: Steinig, Eike , Aglua, Izzard , Duchene, Sebastian , Meehan, Michael , Yoannes, Mition , Firth, Cadhla , Jaworski, Jan , Drekore, Jimmy , Urakoko, Bohu , Poka, Harry , Wurr, Clive , Ebos, Eri , Nangen, David , Müller, Elke , Mulvey, Peter , Jackson, Charlene , Blomfeldt, Anita , Aamot, Hege , Laman, Moses , Manning, Laurens , Earls, Megan , Coleman, David , Greenhill, Andrew , Ford, Rebecca , Stegger, Marc , Syed, Muhammad , Jamil, Bushra , Monecke, Stefan , Ehricht, Ralf , Smith, Simon , Pomat, William , Horwood, Paul , Tong, Steven , McBryde, Emma
- Date: 2022
- Type: Text , Journal article
- Relation: Proceedings of the National Academy of Sciences of the United States of America Vol. 119, no. 45 (2022), p.
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- Reviewed:
- Description: Community-associated, methicillin-resistant Staphylococcus aureus (MRSA) lineages have emerged in many geographically distinct regions around the world during the past 30 y. Here, we apply consistent phylodynamic methods across multiple community-associated MRSA lineages to describe and contrast their patterns of emergence and dissemination. We generated whole-genome sequencing data for the Australian sequence type (ST) ST93-MRSA-IV from remote communities in Far North Queensland and Papua New Guinea, and the Bengal Bay ST772-MRSA-V clone from metropolitan communities in Pakistan. Increases in the effective reproduction number (Re) and sustained transmission (Re > 1) coincided with spread of progenitor methicillin-susceptible S. aureus (MSSA) in remote northern Australian populations, dissemination of the ST93-MRSA-IV genotype into population centers on the Australian East Coast, and subsequent importation into the highlands of Papua New Guinea and Far North Queensland. Applying the same phylodynamic methods to existing lineage datasets, we identified common signatures of epidemic growth in the emergence and epidemiological trajectory of community-associated S. aureus lineages from America, Asia, Australasia, and Europe. Surges in Re were observed at the divergence of antibiotic-resistant strains, coinciding with their establishment in regional population centers. Epidemic growth was also observed among drug-resistant MSSA clades in Africa and northern Australia. Our data suggest that the emergence of community-associated MRSA in the late 20th century was driven by a combination of antibiotic-resistant genotypes and host epidemiology, leading to abrupt changes in lineage-wide transmission dynamics and sustained transmission in regional population centers. Copyright © 2022 the Author(s).
- Authors: Steinig, Eike , Aglua, Izzard , Duchene, Sebastian , Meehan, Michael , Yoannes, Mition , Firth, Cadhla , Jaworski, Jan , Drekore, Jimmy , Urakoko, Bohu , Poka, Harry , Wurr, Clive , Ebos, Eri , Nangen, David , Müller, Elke , Mulvey, Peter , Jackson, Charlene , Blomfeldt, Anita , Aamot, Hege , Laman, Moses , Manning, Laurens , Earls, Megan , Coleman, David , Greenhill, Andrew , Ford, Rebecca , Stegger, Marc , Syed, Muhammad , Jamil, Bushra , Monecke, Stefan , Ehricht, Ralf , Smith, Simon , Pomat, William , Horwood, Paul , Tong, Steven , McBryde, Emma
- Date: 2022
- Type: Text , Journal article
- Relation: Proceedings of the National Academy of Sciences of the United States of America Vol. 119, no. 45 (2022), p.
- Full Text:
- Reviewed:
- Description: Community-associated, methicillin-resistant Staphylococcus aureus (MRSA) lineages have emerged in many geographically distinct regions around the world during the past 30 y. Here, we apply consistent phylodynamic methods across multiple community-associated MRSA lineages to describe and contrast their patterns of emergence and dissemination. We generated whole-genome sequencing data for the Australian sequence type (ST) ST93-MRSA-IV from remote communities in Far North Queensland and Papua New Guinea, and the Bengal Bay ST772-MRSA-V clone from metropolitan communities in Pakistan. Increases in the effective reproduction number (Re) and sustained transmission (Re > 1) coincided with spread of progenitor methicillin-susceptible S. aureus (MSSA) in remote northern Australian populations, dissemination of the ST93-MRSA-IV genotype into population centers on the Australian East Coast, and subsequent importation into the highlands of Papua New Guinea and Far North Queensland. Applying the same phylodynamic methods to existing lineage datasets, we identified common signatures of epidemic growth in the emergence and epidemiological trajectory of community-associated S. aureus lineages from America, Asia, Australasia, and Europe. Surges in Re were observed at the divergence of antibiotic-resistant strains, coinciding with their establishment in regional population centers. Epidemic growth was also observed among drug-resistant MSSA clades in Africa and northern Australia. Our data suggest that the emergence of community-associated MRSA in the late 20th century was driven by a combination of antibiotic-resistant genotypes and host epidemiology, leading to abrupt changes in lineage-wide transmission dynamics and sustained transmission in regional population centers. Copyright © 2022 the Author(s).
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