Methicillin-resistant Staphylococcus aureus as a cause of invasive infections in Central Africa: a case report and review of the literature

• Published in: Infection Vol. 42; no. 3; pp. 451 - 457
• Main Authors: Huson, M. A. M., Kalkman, R., Remppis, J., Beyeme, J. O., Kraef, C., Schaumburg, F., Alabi, A. S., Grobusch, M. P.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-06-2014; Springer Nature B.V
• Subjects: Antibiotics; Bacteremia - diagnosis; Bacteremia - epidemiology; Bacteremia - microbiology; Bacteremia - pathology; Cameroon - epidemiology; Community-Acquired Infections - diagnosis; Community-Acquired Infections - epidemiology; Community-Acquired Infections - microbiology; Community-Acquired Infections - pathology; Epidemiology; Family Medicine; Female; Gabon - epidemiology; General Practice; Human immunodeficiency virus; Humans; Infectious Diseases; Internal Medicine; Medicine; Medicine & Public Health; Methicillin-Resistant Staphylococcus aureus - isolation & purification; Mycobacterium; Pericarditis - complications; Pericarditis - diagnosis; Pericarditis - microbiology; Pericarditis - pathology; Pneumonia, Staphylococcal - complications; Pneumonia, Staphylococcal - diagnosis; Pneumonia, Staphylococcal - microbiology; Pneumonia, Staphylococcal - pathology; Prevalence; Review; Staphylococcal Infections - diagnosis; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcal Infections - pathology; Staphylococcus aureus; Young Adult; Gabon; Cameroon; Africa; Pneumonia; Invasive infections; Central Africa; Epidemiology; Bacteremia; MRSA
• ISSN: 0300-8126; 1439-0973
• DOI: 10.1007/s15010-014-0589-1

Introduction
Community-acquired methicillin-resistant
Staphylococcus aureus
(CA-MRSA) colonization and infection are increasingly being reported worldwide and are associated with severe illness. The vast majority of MRSA infections are skin and soft tissue infections, while invasive disease remains rare. In Western countries, the epidemiology of MRSA is well documented, but from Central Africa, reports on MRSA are very limited.
Methods
Case presentation and review of the literature. The clinical features, epidemiology, and characteristics of MRSA in Central Africa, as well as the treatment options, are discussed. We present a case of severe invasive CA-MRSA infection with pneumonia, pericarditis, and bacteremia in a previously healthy young woman in Gabon. Several virulence factors, like Panton–Valentine leukocidin and type I arginine catabolic mobile element, may play a role in the ability of CA-MRSA to cause severe invasive infections. Based on studies from Gabon and Cameroon (no reports were available from other countries), we find that the prevalence of MRSA is relatively low in this region. Treatment depends primarily on local prevalence and resistance profile of MRSA combined with clinical characteristics.
Conclusion
Severe invasive infection with CA-MRSA is a rare disease presentation in Central Africa, where this pathogen is still relatively uncommon. However, cases of MRSA may be complicated by the human immunodeficiency virus (HIV) and tuberculosis epidemics, and also the limited availability of effective antibiotics.