Research Article
Genotypic and Phenotypic Characterizations of
Methicillin-Resistant Staphylococcus aureus (MRSA) on
Frequently Touched Sites from Public Hospitals in South Africa
Siyethaba Mkhize,
1,2
Daniel G. Amoako ,
3
Christiana O. Shobo,
1
Oliver T. Zishiri ,
2
and Linda A. Bester
1
1
Biomedical Resource Unit, School of Laboratory Medicine and Medical Sciences, College of Health Sciences,
University of KwaZulu-Natal, Durban 4000, South Africa
2
Discipline of Genetics, School of Life Sciences, College of Agriculture Engineering and Science, University of KwaZulu-Natal,
Durban 4000, South Africa
3
Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
Correspondence should be addressed to Linda A. Bester; besterl@ukzn.ac.za
Received 24 July 2021; Accepted 1 October 2021; Published 23 October 2021
Academic Editor: Joseph Falkinham
Copyright © 2021 Siyethaba Mkhize et al. is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
e hospital environment acts as a reservoir in the transmission of pathogens, such as MRSA, which may cause hospital-acquired
infections. is study aimed to ascertain the prevalence, genetic relatedness, antibiotic resistance, and virulence profile of MRSA on some
frequently touched hospital sites in South Africa. A total of 777 swabs were randomly collected from 11 frequently touched sites in the
hospital environment of three wards of four public hospitals in the KwaZulu-Natal province of South Africa. Isolation of S. aureus and
confirmation were done using genotypic and phenotypic methods. Antibiotic susceptibility testing was performed using the Kir-
by–Bauer disk-diffusion method. MRSA isolates were determined by the presence of the mecA gene. Virulence and resistance genes were
detected using a standard monoplex PCR assay. ERIC-PCR was conducted to evaluate the genetic relatedness. An overall prevalence of
12.7% for S.aureus isolates was obtained. Out of these, 89.9% (89/99) were confirmed to be MRSA. e sites with the highest prevalence
were the occupied beds (16.2% (16/99)), unoccupied beds (16.2% (16/99)), patient files (14.1% (14/99)), ward phones (13.1% (13/99)), and
nurses’ tables (14.1% (14/99)). e virulence genes with the highest observed frequency were hld (87 (87.9%)) and LukS/F-PV (53
(53.5%)). e resistance genes with the highest frequency were the tetM and tetK genes detected in 60 (60.6%) and 57 (57.6%) isolates,
respectively. e ERIC-PCR results obtained indicated a high level of genetic diversity; however, intraclonal (within a hospital) and
interclonal (between hospitals) clusters of MRSA were observed. e study showed that MRSA can contaminate various surfaces, and
this persistence allows for the dissemination of bacteria within the hospital environment. is highlights the need for improved infection
prevention and control (IPC) strategies in public hospitals in the country to curb their potential transmission risks.
1. Introduction
A hospital-acquired infection (HAI) or nosocomial in-
fection develops during hospitalisation or within 48 hours
after the patient has been discharged. In most cases, this is
not the initial cause of hospital admission [1]. Staphylo-
coccus aureus (S. aureus) is considered one of the most
important [2] pathogens responsible for HAIs. HAIs are a
financial burden in developed and developing countries
causing significant strain on the economy due to the high
cost of treatments and increased mortality and morbidity
rates that are associated with these types of infections [3–5].
In addition, S. aureus is one of eight significant pathogens
listed by the Global Antimicrobial Resistance Surveillance
System (GLASS) alongside Shigella spp., Salmonella spp.,
Streptococcus pneumoniae, Klebsiella pneumoniae, Neisse-
ria gonorrhoeae, Acinetobacter spp., and Escherichia coli
[6].
Hindawi
International Journal of Microbiology
Volume 2021, Article ID 6011045, 9 pages
https://doi.org/10.1155/2021/6011045