Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) are a major cause of healthcare and community- associated infections due to their ability to express a variety of virulence factors. We investigated 209 MRSA isolates obtained from 1 January to 31 December 2016 using a combination of phenotypic and genotypic methods to understand the genetic backgrounds of MRSA strains obtained in a General hospital in Kuwait. Antibiotics susceptibility was performed with disk diffusion, and MIC was measured with Etest strips. Molecular typing was performed using SCCmec typing, spa typing, and DNA microarray for antibiotic resistance and virulence genes. The isolates were susceptible to vancomycin, teicoplanin, rifampicin, ceftaroline, and linezolid but were resistant to gentamicin, tetracycline, erythromycin, fusidic acid, chloramphenicol and ciprofloxacin. Molecular typing revealed six SCCmec types, 56 spa types and 16 clonal complexes (CC). The common SCCmec types were type IV (39.5%), type III (34.4%), type V (25.8%) and type VI (3.8%). The dominant spa types were t860 (23.9%), t945 (8.6%), t127 (6.7%), t688 (6.7%), t304 (6.2) and t044 (5.7%). The other spa types occurred sporadically. Genes for PVL was detected in 59 (28.2%) of the isolates. CC8-ST239-MRSA-III + SCCmer (23.3%) was the most prevalent clone, followed by CC6-MRSA-IV (8.3%), CC80-MRSA-IV [PVL+] (5.8%), CC5-MRSA-VI + SCCfus (5.0%), CC30-MRSA-IV[PVL+] (4.1%), CC1-MRSA-V + SCCfus [PVL+] (4.1%), CC5-MRSA-V + SCCfus (4.1%) and CC22-MRSA-IV[PVL+] (4.1%). The study revealed that despite the emergence of MRSA with diverse genetic backgrounds over the years, ST239-MRSA-III remained the dominant clone in the hospital. This warrants reassessment of infection prevention and control procedures at this hospital.
Highlights
Methicillin-resistant Staphylococcus aureus (MRSA) is an opportunistic pathogen that can cause mild to invasive, life-threatening infections[1], MRSA was first reported in the United Kingdom, soon after the use of methicillin in the healthcare system in the 1960’s2, but have since been reported in many countries[3,4,5]
We examined MRSA isolates analysed by DNA microarray according to their clinical sources to establish any specific association between clones and clinical sources and infection types
The results of the present study have provided updates on the distribution and types of MRSA clones that circulated in the hospital in 2016
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) is an opportunistic pathogen that can cause mild to invasive, life-threatening infections[1], MRSA was first reported in the United Kingdom, soon after the use of methicillin in the healthcare system in the 1960’s2, but have since been reported in many countries[3,4,5]. SCCmec typing[9,10], and other molecular typing methods including pulsed-field gel electrophoresis, multilocus sequence typing, Staphylococcal protein A (Spa) typing, DNA microarray and whole genome sequencing[5,6,11,12,13], have been employed to investigate the clonal distributions of MRSA strains in different countries, and have revealed a diversity in their genetic backgrounds in the different geographical locations. This study was conducted on MRSA isolates obtained from patients admitted to the Farwaniya hospital in 2016 to determine their antibiotic resistance patterns and clonal distribution and compare the results to those obtained in 1996– 2001 for the purpose of assisting in patients’ management and control of infections, and to compare the MRSA clones to those in other Kuwait hospitals
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