Molecular landscape of methicillin-resistant Staphylococcus aureus strains in clinical infections from hospitals in Lagos, Nigeria

Background and objectives

Multidrug-resistant Staphylococcus aureus (MRSA) accounts for a significant proportion of antimicrobial resistance (AMR)-associated infections worldwide. This study investigated the molecular profile of MRSA in Nigeria, providing valuable genomic data to fill existing knowledge gaps and highlighting its importance in the context of the global AMR crisis.

Methods

A total of 107 isolates were obtained from patient samples, including wound swabs/pus (65 isolates, 60.7%), blood cultures (16 isolates, 15%), urine/urinary catheter (8 isolates, 7.5%) and other sources. Species identification was performed using MALDI-TOF, and antimicrobial susceptibility testing was performed using the VITEK®2 system. Genomic DNA was extracted and subjected to whole-genome sequencing using short-read Illumina technology. In addition, a subset of isolates underwent long-read sequencing using Oxford Nanopore technology.

Results

Among the 107 isolates, 63 (59%) were identified as MRSA, with 58 (92%) carrying the mecA gene. The MRSA isolates exhibited high resistance to non-β-lactam antibiotics, particularly trimethoprim/sulfamethoxazole (95.3%), erythromycin (76.6%), gentamicin (71.4%) and quinolones (69.8%). The most prevalent MRSA belonged to the Bengal Bay clone [t657/ST772/Staphylococcal Cassette Chromosome mec (SCCmec) V(5C2)/Panton-Valentine leukocidin (PVL) + methicillin-susceptible Staphylococcus aureus (MRSA)], followed by t4690/ST152/SCCmec Vc(5C2&5)/PVL + MRSA and ST8 (t008, n = 1; t064, n = 4)/SCCmec Vc(5C2&5). Phylogenetic analysis suggests both community/associated transmission and possible importation of strains.

Conclusions

This study highlights the significant burden of MRSA in Nigeria, with the high-risk Bengal Bay MRSA clone as the most common strain. The widespread resistance to non-β-lactam antibiotics underscores the urgent need for enhanced surveillance, infection control and antibiotic stewardship to mitigate its spread.