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Antibiotic-resistant staphylococci in South Africa one health approach
Thesis (PhD)--Stellenbosch University, 2024.
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Stellenbosch : Stellenbosch University
2025
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| _version_ | 1867613955219783680 |
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| access_status_str | Open Access |
| author | Ocloo, Remous |
| author2 | Whitelaw, Andrew Christopher |
| author_browse | Ocloo, Remous Whitelaw, Andrew Christopher |
| author_facet | Whitelaw, Andrew Christopher Ocloo, Remous |
| author_sort | Ocloo, Remous |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description |
Thesis (PhD)--Stellenbosch University, 2024. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/131872 |
| institution | Stellenbosch University (South Africa) |
| last_indexed | 2026-06-10T12:44:21.913Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/131872 Antibiotic-resistant staphylococci in South Africa one health approach Ocloo, Remous Whitelaw, Andrew Christopher Newton-Foot, Mae Ziebuhr, Wilma Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Pathology (Medical Microbiology). Staphylococcal infections -- South Africa Multidrug resistance -- South Africa One health -- South Africa Medical microbiology -- South Africa UCTD Thesis (PhD)--Stellenbosch University, 2024. ENGLISH ABSTRACT: Staphylococci cause a wide range of infections in humans and animals, with Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis and Staphylococcus haemolyticus the most common Staphylococcus species implicated in healthcare and community acquired infections. The emergence and dissemination of antibiotic resistance (ABR) among Staphylococcus species has complicated empiric treatment practices and limited treatment options, leading to increased mortality. The World Health Organization (WHO, 2015) declared antimicrobial resistance a threat to the treatment of infections. The “One Health” initiative addresses health care challenges holistically by including human health, animal health and environmental health to achieve better public health outcomes. This approach is being adopted by the WHO to mitigate the problem of ABR and research across these sectors is required. This study investigated ABR rates and described the molecular resistance mechanisms and population structures of staphylococci from community, clinical and farm settings. This was achieved by employing both traditional culture and phenotypic antibiotic susceptibility testing as well as whole genome sequencing. A systematic review was conducted to understand trends, strengths, and limitations in the area of ABR in staphylococci other than Staphylococcus aureus (SOSA) in animals. The findings suggested that there is high tetracycline and penicillin resistance among SOSA organisms in livestock and companion animals in Africa. The review also highlighted the lack of strain typing of SOSA in Africa and that research was more focused on cattle. To employ a One Health approach, this study therefore included pigs, which are common livestock in the Western Cape province of South Africa, stool samples from healthy children in the community, and clinical isolates. S. haemolyticus and S. epidermidis were identified in all three settings, and S. borealis was identified from the pigs and the healthy community-based children, the first report of this species in Africa. High rates of tetracycline resistance were observed amongst pigs and human contacts on the pig farms. The majority of the healthy community-based children were colonised by methicillin resistant SOSA, and in the clinical isolates high rates of multidrug resistance were observed. The distribution of tetracycline resistance suggests that pig farms might be a “hotspot” for tetracycline resistance which is then transferred via the community with moderate resistance rates, to clinical settings with lower rates of tetracycline resistance. The tetracycline resistance gene tetK was seen across all selected settings in SOSA, as was the erythromycin resistance gene, ermC. No common strain types were circulating across all selected settings. However, certain S. haemolyticus strain types were identified in community and clinical settings. Our ability to conclude on genetic relatedness in the selected settings was limited by inconsistent species distribution and sample size. The findings suggest that S. haemolyticus is predominant in the community and might be spreading into the clinical and farm settings while Mammaliicoccus sciuri is predominant in the farm setting with potential dissemination into the community. Although the number of Staphylococcus aureus from the study was small, SOSA were more resistant than S. aureus with diverse antibiotic resistance genes; evidence of SOSA as a reservoir of ABR genes. AFRIKAANSE OPSOMMING: Stafilokokke veroorsaak 'n wye reeks infeksies in mense en diere, met Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis en Staphylococcus haemolyticus die mees algemene Staphylococcus spesies wat betrokke is by gesondheidsorg en gemeenskapverworwe infeksies. Die opkoms en verspreiding van antibiotikaweerstandigheid (ABR) onder Staphylococcus spesies het empiriese behandelingspraktyke gekompliseer en behandelingsopsies beperk, wat lei tot verhoogde mortaliteit. Die Wêreldgesondheidsorganisasie (WHO, 2015) het antimikrobieseweerstand as 'n bedreiging vir die behandeling van infeksies verklaar. Die "One Health"-inisiatief spreek gesondheidsorguitdagings holisties aan deur menslike-, diere- en omgewingsgesondheid in te sluit om beter publieke gesondheidsuitkomste te bereik. Hierdie benadering word deur die WHO aangeneem om die probleem van ABR op te los en navorsing wat span oor hierdie sektore word vereis. Hierdie studie het ABR-patrone ondersoek en die molekulêre weerstandsmeganismes en populasiestrukture van stafilokokke uit gemeenskaps-, kliniese en plaasomgewings beskryf. Dit is bereik deur gebruik te maak van beide tradisionele kweek- en fenotipiese antibiotikavatbaarheidstoetse sowel as heelgenoomvolgordebepaling. 'n Sistematiese oorsig is uitgevoer om tendense, sterkpunte en beperkings op die gebied van ABR by Stafilokokke anders as Staphylococcus aureus (SOSA) by diere te verstaan. Die bevindinge het voorgestel dat daar hoë tetrasiklien- en penisillienweerstandigheid onder SOSA-organismes in vee en troeteldiere in Afrika is. Die oorsig het ook uitgelig dat daar ‘n gebrek aan stamtipering van SOSA in Afrika is en dat navorsing meer op beeste fokus. Om ‘n "One Health" benadering aan te neem het hierdie studie dus varke, wat algemene vee in die Wes-Kaap provinsie van Suid-Afrika is, stoelgangmonsters van gesonde kinders in die gemeenskap, sowel as kliniese isolate ingesluit. S. haemolyticus en S. epidermidis is in al drie omgewings iv https://scholar.sun.ac.za geïdentifiseer, en S. borealis is geïdentifiseer by varke en die gesonde gemeenskapsgebaseerde kinders, die eerste verslag van hierdie spesie in Afrika. Hoë vlakke van tetrasiklienweerstandigheid is onder varke en menslike kontakte op die varkplase waargeneem. Die meerderheid van die gesonde gemeenskapsgebaseerde kinders is deur metisillienweerstandige SOSA gekoloniseer, en in die kliniese isolate is hoë vlakke van multigeneesmiddelweerstandigheid waargeneem. Die verspreiding van tetrasiklienweerstandigheid dui daarop dat varkplase 'n brandpunt vir tetrasiklienweerstandigheid kan wees wat dan deur die gemeenskap met matige weerstandskoerse oorgedra word na kliniese omgewings met laer tetrasiklienweerstandigheidskoerse. Die tetrasiklienweerstandsgeen tetK is in SOSA in alle omgewings gevind, asook die eritromisienweerstandsgeen, ermC. Geen algemene stamtipes is in al die geselekteerde omgewings gevind nie. Sekere S. haemolyticus stamtipes is egter in gemeenskaps- en kliniese omgewings geïdentifiseer. Ons vermoë om afleidings te maak oor genetiese verwantskap in die geselekteerde omgewings is beperk deur oneweredige spesieverspreiding en monstergrootte. Die bevindinge dui daarop dat S. haemolyticus oorheersend in die gemeenskap is en moontlik na die kliniese en plaasomgewings kan versprei, terwyl Mammaliicoccus sciuri oorheersend in die plaasomgewing is met potensiële verspreiding na die gemeenskap. Alhoewel die aantal Staphylococcus aureus laag was, was SOSA meer weerstandig as S. aureus, met diverse ABR gene; ‘n bewys dat SOSA as reservoir van ABR-gene dien. Doctoral 2025-04-04T10:20:18Z 2025-04-04T10:20:18Z 2024-12 Thesis https://scholar.sun.ac.za/handle/10019.1/131872 Stellenbosch University xiv, 136 pages application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Staphylococcal infections -- South Africa Multidrug resistance -- South Africa One health -- South Africa Medical microbiology -- South Africa UCTD Ocloo, Remous Antibiotic-resistant staphylococci in South Africa one health approach |
| title | Antibiotic-resistant staphylococci in South Africa one health approach |
| title_full | Antibiotic-resistant staphylococci in South Africa one health approach |
| title_fullStr | Antibiotic-resistant staphylococci in South Africa one health approach |
| title_full_unstemmed | Antibiotic-resistant staphylococci in South Africa one health approach |
| title_short | Antibiotic-resistant staphylococci in South Africa one health approach |
| title_sort | antibiotic resistant staphylococci in south africa one health approach |
| topic | Staphylococcal infections -- South Africa Multidrug resistance -- South Africa One health -- South Africa Medical microbiology -- South Africa UCTD |
| url | https://scholar.sun.ac.za/handle/10019.1/131872 |
| work_keys_str_mv | AT oclooremous antibioticresistantstaphylococciinsouthafricaonehealthapproach |