TITLE:
Epidemiology of Staphylococcus aureus Infections in Kenya: Current State, Gaps and Opportunities
AUTHORS:
Justin Nyasinga, Geoffrey Omuse, Njenga John, Andrew Nyerere, Shima Abdulgader, Mae Newton, Andrew Whitelaw, Gunturu Revathi
KEYWORDS:
Staphylococcus aureus, MRSA, AMR, Epidemiology, Kenya
JOURNAL NAME:
Open Journal of Medical Microbiology,
Vol.10 No.4,
December
18,
2020
ABSTRACT: Staphylococcus aureus has maintained its clinical relevance as a major cause of hospital and
community acquired infections globally with a high burden of antimicrobial
resistance (AMR). Though reported, the burden of infection, antimicrobial
resistance and molecular epidemiology of S. aureus are not well defined in Kenya. This descriptive
review evaluated reported data on the detection and characterization of S. aureus infections in Kenya.
Published data between 2000 and 2020 were evaluated. S. aureus isolation frequencies
varied from 1% in blood specimens to 52.6% among skin and soft tissues
infections while MRSA rates ranged from 1% to 84.1%. While penicillin
resistance has consistently been high, last line and recent antibiotics such as
vancomycin, linezolid, teicoplanin and daptomycin have retained their efficacy.
Data on MRSA carriage in the community, among HCWs and inpatients is limited.
Global clones (CC1, CC5, CC8, CC22, CC30, CC45 and CC239) alongside a few novel
MRSA strains have been reported with staphylococcal protein A (spa)
sequence based clustering yielding four major clusters (spa CC359, spa CC005, spa CC121 and spa CC021) in circulation. MRSA strain
ST239/241 (t037) seems predominant in the country. Despite a clear paucity of
data, the present analysis points to a high infection and AMR burden in S. aureus with global MRSA
clones in circulation. Standardized national surveillance and reporting
incorporating molecular tools for identification and characterization will help
fill existing gaps in the understanding of the evolving epidemiology of MRSA
infections.