Wound colonization with methicillin-resistant Staphylococcus aureus and hypotheses about acquisition routes in rural healthcare settings in Sub-Saharan Africa: Perspective from a Center devoted to the treatment of cutaneous neglected tropical diseases.

We identified a high prevalence (46.4%) of wound colonization with methicillin-resistant Staphylococcus aureus (MRSA) in patients hospitalized in a Center devoted to the treatment of cutaneous tropical diseases in Benin. The proportion of MRSA among S. aureus isolates was 54.3%. Thirty percent of these MRSA were identified in outpatients. Concurrently, 51% of MRSA were identified in patients for whom the time spent in the Center was between 20 days and 228 days. The analysis of pulsed-field gel electrophoresis demonstrated an important diversity of strains but also identified eight small clusters containing between two and four isolates suggesting cross-transmission. Based on these data, hypotheses about acquisition routes were suggested and measures for limiting the burden of antimicrobial resistance were envisaged.

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