Molecular epidemiology and antimicrobial resistance mechanisms in staphylococci from various geographic regions in Africa

• Applicant: Privatdozentin Dr. Wilma Ziebuhr
• Subject Area: Medical Microbiology and Mycology, Hygiene, Molecular Infection Biology
• Term: since 2017
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 317107333

Antimicrobial resistance (AMR) of bacterial pathogens is an ongoing and increasing issue which was identified by the World Health Organization (WHO) to have the potential to threaten the achievements of modern medicine. AMR strikes all regions worldwide, including the African continent; and international travel, trade and exchange favor the rapid global spread of multidrug-resistant isolates. To counteract this development, a holistic approach is needed that takes into account the local resistance situation while being aware of the global dimension of the problem. In this project, medical microbiologists from Egypt, Kenya and South Africa work together with molecular infection biologists from Germany to address AMR in staphylococci, a group of Gram-positive bacteria that represent common human and veterinary pathogens and in which AMR is particularly pronounced. Staphylococci readily acquire many different resistance genes, and methicillin-resistant Staphylococcus aureus (MRSA) and coagulase-negative staphylococci (MR-CoNS) are among the most common causes of healthcare-associated infections in the participating countries and worldwide. However, MRSA and MR-CoNS also occur outside of medical facilities and are detectable in the community, in animal husbandries as well as in the environment. By adopting the One Health approach (which considers in addition to human medicine also the veterinary sector and the environment) we were previously able to fill the knowledge gap on staphylococcal epidemiology in Africa by generating comprehensive insight into the AMR situation in staphylococci currently circulating in the three participating African regions. We will take this information as a basis for detailed studies to underpin the epidemiological data with molecular markers being associated with CoNS pathogenicity and distinct AMR phenotypes in the respective African centers. Precisely, we will focus on beta-lactam resistance and early signs of resistance development to formerly last resort antibiotics such as linezolid and daptomycin. A key aspect of our work is to support local antibiotic stewardship programmes by providing molecular data for rational decision making in order to reduce the uncritical use particularly of broad spectrum antibiotics. This will not only contribute to cost effectiveness in the public health sector, but also diminish the selective pressure on other AMR bacteria of major concern, thereby (in the long run) decreasing the overall burden of AMR pathogens. We feel that with this project we can make a major contribution to improve both diagnostics and treatment of patients at the three African sites.

• DFG Programme: Research Grants
• International Connection: Egypt , Kenya, South Africa
• Cooperation Partners: Professorin Adrie Bekker, Ph.D.; Professor Richard H. Glashoff, Ph.D.; Professorin Dr. Ulrike Holzgrabe
• International Co-Applicants: Professorin Alaa Abouelfetouh, Ph.D.; Professorin Dr. Gunturu Revathi; Professor Dr. Andrew Whitelaw