Clonal lineages, antimicrobial resistance and virulence of MRSA isolates recovered from piglets, farm workers and households in the two independent farms, Farm A and Farm B.

<p>Clonal lineages, antimicrobial resistance and virulence of MRSA isolates recovered from piglets, farm workers and households in the two independent farms, Farm A and Farm B.</p

Identification of <i>Staphylococcus aureus</i>, including MRSA, among nursing students.

<p>Identification of <i>Staphylococcus aureus</i>, including MRSA, among nursing students.</p

Schematic representation of the interpersonal direct contact between individuals and between individuals and livestock, associated to the distribution of the different MRSA lineages.

<p>Schematic representation of the interpersonal direct contact between individuals and between individuals and livestock, associated to the distribution of the different MRSA lineages.</p

Characteristics of methicillin-susceptible <i>Staphylococcus aureus</i> recovered from nursing students.

<p>Characteristics of methicillin-susceptible <i>Staphylococcus aureus</i> recovered from nursing students.</p

Contamination of vehicles sampled more than once during the study period.

<p>Horizontal numbers on the top of the figure represent de year and month of sampling. Vertical numbers correspond to the 47 vehicles identification.</p

Molecular characterization of 72 MRSA isolates from public buses and 21 MRSA isolates from human carriage (hands and nasal).

<p>HA – Healthcare associated; CA – Community-associated.</p><p>ST – Sequence type.</p><p>nt – non-typeable.</p

Characterization of representative MRSA isolates and comparison with MRSA pandemic clones.

<p>From left to right: (i) dendrogram, showing the estimated relationships of PFGE types based on Bionumerics analysis, including representatives of two international pandemic MRSA clones (EMRSA-15 and Pediatric clone); (ii) list of isolates; (iii) isolation date; (iv) PFGE type; (v) <i>spa</i> type; (vi) MLST sequence type (ST); (vii) SCC<i>mec</i> type; (viii) antibiotype (ATB); and (ix) antibiogram. R - resistance, I - intermediate susceptibility, S - susceptibility; Antibiotic abbreviations: OX – oxacillin, AMP – ampicillin, FOX – cefoxitin, AMC - amoxicillin-clavulanic acid, CIP – ciprofloxacin, E – erythromycin, AZM – azithromycin, IPM – imipenem, K – kanamycin, TOB – tobramicin, CN – gentamicin.</p

Buses lines data and PFGE types found in the different vehicles contaminated with MRSA.

(a)<p>Two bus lines were assigned to the same vehicle during the screening day.</p>(b)<p>Number of hospitals on each bus route.</p>(c)<p>Each column corresponds to different buses assigned to the same bus line. Date of screening: day/month/year.</p

A five-year retrospective study shows increasing rates of antimicrobial drug resistance in Cabo Verde for both Staphylococcus aureus and Escherichia coli.

OBJECTIVES: Data on baseline drug resistance is important in informing future antimicrobial stewardship programs. So far, no data on the antimicrobial drug resistance of clinical isolates was available for the African archipelago of Cabo Verde. METHODS: We have performed a retrospective analysis over five-years (2013-17) of the antimicrombial drug susceptibility profiles of clinical isolates in the two main hospitals of Cabo Verde. For Escherichia coli and Staphylococcus aureus, representing respectively 47% and 26% of all clinical isolates, the antimicrobial drug resistance profile was reported for six representative drugs. RESULTS: For E. coli we detected an increase in resistance to ampicillin, amoxicillin/clavulanic acid, ceftriaxone, ciprofloxacin, and trimethoprim-sulfamethoxazole and for S. aureus to methicillin, erythromycin and trimethoprim-sulfamethoxazole. This increase in both the most commonly isolated bacterial pathogens is of alarm as it might compromise empirical treatment in a setting with limited access to laboratory testing. CONCLUSIONS: When compared to the published low resistance rates in carriage isolates, the more alarming situation in clinical isolates for S. aureus might encourage antimicrobial stewardship programs to reduce MRSA in the hospital settings, possibly as part of the Cabo Verdean national plan against antimicrobial drug resistance