Staphylococcus aureus Nasopharyngeal Carriage and Antimicrobial Resistance among Adults with Sickle Cell Disease at the Korle Bu Teaching Hospital in Accra, Ghana

Nicholas Tkd Dayie; Deborah Nk Sekoh; Patience B Tetteh-Quarcoo; Alberta D Dayie; Mary-Magdalene Osei; Fleischer Cn Kotey; Eric S Donkor

doi:10.1177/11786361221133959

Staphylococcus aureus Nasopharyngeal Carriage and Antimicrobial Resistance among Adults with Sickle Cell Disease at the Korle Bu Teaching Hospital in Accra, Ghana

Microbiol Insights. 2022 Oct 31:15:11786361221133959. doi: 10.1177/11786361221133959. eCollection 2022.

Authors

Nicholas Tkd Dayie¹, Deborah Nk Sekoh^{1

2}, Patience B Tetteh-Quarcoo¹, Alberta D Dayie³, Mary-Magdalene Osei^{1

2}, Fleischer Cn Kotey^{1

3}, Eric S Donkor¹

Affiliations

¹ Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana.
² FleRhoLife Research Consult, Teshie, Accra, Ghana.
³ Department of Chemistry, University of Cape Coast, Cape Coast, Ghana.

Abstract

Background: Sickle cell disease (SCD) patients are an important risk group for Staphylococcus aureus (S. aureus) carriage and infections. Little is, however, known about the nasopharyngeal carriage epidemiology of the pathogen in this vulnerable population.

Aim: The aim of this study was to evaluate S. aureus and methicillin-resistant S. aureus (MRSA) nasopharyngeal carriage prevalence, carriage determinants, and antimicrobial resistance among SCD adults in Ghana.

Methodology: Nasopharyngeal swabs, obtained from 200 SCD adults recruited at the Korle Bu Teaching Hospital, were cultured for S. aureus, and these isolates were subjected to antimicrobial susceptibility testing via the Kirby-Bauer method.

Results: The prevalence of S. aureus carriage was 41.5% (n = 83), and that of MRSA carriage was 1.0% (n = 2). Moreover, carriage of coagulase-negative Staphylococcus (CoNS) was the only determinant of S. aureus carriage identified (OR = 0.012, P < .0001). However, neither this variable nor the other features of the participants emerged as a determinant of MRSA carriage. The antimicrobial resistance rates decreased across penicillin (98.8%, n = 82), tetracycline (54.2%, n = 45), gentamicin (32.5%, n = 27), ciprofloxacin (21.7%, n = 18), erythromycin (18.1%, n = 15), clindamycin (10.8%, n = 9), amoxicillin-clavulanic acid (10.8%, n = 9), teicoplanin (1.2%, n = 1), and linezolid (0.0%, n = 0), and the multidrug resistance rate was 45.8% (n = 38).

Conclusion: The nasopharyngeal carriage prevalence of S. aureus in the current study was high, while that of MRSA was low. The isolates were highly resistant to several of the antibiotics tested, but not teicoplanin and linezolid, making these antibiotics suitable for treatment of S. aureus infections among the SCD population.

Keywords: MRSA; Sickle cell disease; Staphylococcus aureus; antimicrobial resistance; multidrug resistant; nasopharyngeal carriage.