Characterisation of MRSA strains isolated from patients in a hospital in Riyadh, Kingdom of Saudi Arabia

Stefan Monecke,Peter Slickers,Ralf Ehricht,Antje Ruppelt,Leila Skakni,Ahmed Hakawi,Sameeh S Ghazal,Rami Hasan

doi:10.1186/1471-2180-12-146

Abstract

BackgroundMethicillin-resistant Staphylococcus aureus (MRSA) is spreading worldwide and poses a serious public health problem, being present in hospital settings and communities. However, from the Middle East and the Arabian Peninsula few molecular typing data on MRSA strains are currently available. In order to obtain data on the population structure of MRSA in Riyadh, Saudi Arabia, 107 clinical and environmental MRSA isolates were genotyped using a microarray-based assay.ResultsFive major MRSA strains from four clonal complexes were identified CC8/ST239-III (20.75%), PVL-positive as well as -negative CC22-IV (18.87% and 9.43%, respectively), PVL-positive CC30-IV (12.26%) and PVL-positive CC80-IV (17.92%). Minor strains, which accounted for less than 3% each, included CC1-IV/SCCfus, PVL-positive CC1/ST772-V, PVL-positive as well as- negative CC5-IV, CC5-IV/SCCfus, CC5-V, CC6-IV, CC45-IV, PVL-negative CC80-IV, PVL-positive CC88-IV, CC97-V and a CC9/ST834-MRSA strain.ConclusionsTyping of MRSA strains from Riyadh revealed a high diversity of clonal complexes. The prevalence of the genes encoding the Panton-Valentine leukocidin was surprisingly high (54.21%), and a significant rate of resistance markers was detected also in strains considered as community-associated.

Highlights

Methicillin-resistant Staphylococcus aureus (MRSA) is spreading worldwide and poses a serious public health problem, being present in hospital settings and communities
Methicillin-resistant Staphylococcus aureus (MRSA) infections remain a major healthcare burden considering the emergence of more virulent community-acquired or -associated MRSA (CA-MRSA) in addition to the longer existent hospital-acquired (HA-) MRSA strains
A striking result of the study was a high diversity of different MRSA strains and clonal complexes as well as a high prevalence of PVL

Summary

Introduction

Methicillin-resistant Staphylococcus aureus (MRSA) is spreading worldwide and poses a serious public health problem, being present in hospital settings and communities. From the Middle East and the Arabian Peninsula few molecular typing data on MRSA strains are currently available. Methicillin-resistant Staphylococcus aureus (MRSA) infections remain a major healthcare burden considering the emergence of more virulent community-acquired or -associated MRSA (CA-MRSA) in addition to the longer existent hospital-acquired (HA-) MRSA strains. Arabia during the 1990s [6] Another pandemic strain, CC22-IV (UK-EMRSA-15) has been detected in Kuwait [7] and Abu Dhabi [2]. PVL-positive strains, which are usually regarded as community-associated, have been found in Kuwait [8], Abu Dhabi [2], Lebanon [9], Egypt [10], Tunisia [11], Algeria [12,13] as well as in people travelling from and to various Middle Eastern countries [14]

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