Abstract
Reports from Arabian Gulf countries have demonstrated emergence of novel methicillin resistant Staphylococcus aureus (MRSA) strains. To address the lack of data from the United Arab Emirates (UAE), genetic characterisation of MRSA identified between December 2017 and August 2019 was conducted using DNA microarray-based assays. The 625 MRSA isolates studied were grouped into 23 clonal complexes (CCs) and assigned to 103 strains. CC5, CC6, CC22 and CC30 represented 54.2% (n/N = 339/625) of isolates with other common CCs being CC1, CC8, CC772, CC361, CC80, CC88. Emergence of CC398 MRSA, CC5-MRSA-IV Sri Lanka Clone and ST5/ST225-MRSA-II, Rhine-Hesse EMRSA/New York-Japan Clone in our setting was detected. Variants of pandemic CC8-MRSA-[IVa + ACME I] (PVL+) USA300 were detected and majority of CC772 strains were CC772-MRSA-V (PVL+), “Bengal- Bay Clone”. Novel MRSA strains identified include CC5-MRSA-V (edinA+), CC5-MRSA-[VT + fusC], CC5-MRSA-IVa (tst1+), CC5-MRSA-[V/VT + cas + fusC + ccrA/B-1], CC8-MRSA-V/VT, CC22-MRSA-[IV + fusC + ccrAA/(C)], CC45-MRSA-[IV + fusC + tir], CC80-MRSA-IVa, CC121-MRSA-V/VT, CC152-MRSA-[V + fusC] (PVL+). Although several strains harboured SCC-borne fusidic acid resistance (fusC) (n = 181), erythromycin/clindamycin resistance (ermC) (n = 132) and gentamicin resistance (aacA-aphD) (n = 179) genes, none harboured vancomycin resistance genes while mupirocin resistance gene mupR (n = 2) and cfr gene (n = 1) were rare. An extensive MRSA repertoire including CCs previously unreported in the region and novel strains which probably arose locally suggest an evolving MRSA landscape.
Highlights
Reports from Arabian Gulf countries have demonstrated emergence of novel methicillin resistant Staphylococcus aureus (MRSA) strains
Based on DNA microarray analysis, these 625 MRSA isolates were grouped into 23 clonal complexes (CCs) which were assigned to 102 strains (Table 1) with “strains” being defined based on their CC affiliation, toxin gene carriage and SCCmec type
In recent years, emerging data globally and in the Arabian Gulf region, have shown an evolving MRSA epidemiology with a shift to predominance of community associated MRSA lineages (CA-MRSA) lineages in nosocomial infections and an emergence of novel strains leading to an increased biological diversity of MRSA strains as well as to a greater diversity of SCCmec elements and variants thereof
Summary
Reports from Arabian Gulf countries have demonstrated emergence of novel methicillin resistant Staphylococcus aureus (MRSA) strains. In recent years, emerging data on the molecular characterisation of S. aureus isolates in the hospital and community setting in countries of the Arabian Gulf region has contributed to changing our understanding of the diversity of isolates p resent[3,4,5,6,7,8,9]. The UAE is a global tourist hub and home to a large expatriate population including those from regions from where there are hardly any data on MRSA prevalence and population structure With this dynamic population, it is plausible that a diversity of MRSA clones can be found that includes highly transmissible pandemic clones as well as local strains from different regions from which tourists and expatriates might come to the UAE. This study was carried out to determine the genotypes of MRSA isolates in the UAE and to differentiate closely related strains using a high-resolution typing method
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