Journal Article

Molecular Characterization of Methicillin- Resistant Staphylococcus aureus in a Tertiary Care hospital in Kuwait

Alosaimi, Asma’a, Modhaffer, Azizah, Alfouzan, Wadha, Udo, Edet E.

2019

Overview

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 SCC mec 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 SCC mec types, 56 spa types and 16 clonal complexes (CC). The common SCC mec 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.

• Publisher: Nature Publishing Group UK,Nature Publishing Group
• Subject: 45 / 45/22 / 45/23 / 45/29 / 45/61 / 45/77 / 631/326/107 / 692/699/255/1318 / Antibiotic resistance / Antibiotics / Chloramphenicol / Ciprofloxacin / Cloning / Community-Acquired Infections - drug therapy / Community-Acquired Infections - epidemiology / Community-Acquired Infections - microbiology / Cross Infection - drug therapy / Cross Infection - epidemiology / Cross Infection - microbiology / DNA microarrays / DNA, Bacterial - genetics / DNA, Bacterial - isolation & purification / Drug resistance / Drug Resistance, Multiple, Bacterial - genetics / Erythromycin / Female / Fusidic acid / Genetic diversity / Gentamicin / Humanities and Social Sciences / Humans / Kuwait - epidemiology / Linezolid / Male / Methicillin / Methicillin - pharmacology / Methicillin - therapeutic use / Methicillin Resistance - genetics / Methicillin-Resistant Staphylococcus aureus - drug effects / Methicillin-Resistant Staphylococcus aureus - genetics / Methicillin-Resistant Staphylococcus aureus - isolation & purification / Methicillin-Resistant Staphylococcus aureus - pathogenicity / Microbial Sensitivity Tests / Minimum inhibitory concentration / Molecular Epidemiology / Molecular Typing / multidisciplinary / Oligonucleotide Array Sequence Analysis / Public health / Rifampin / Science / Science (multidisciplinary) / Staphylococcal Infections - drug therapy / Staphylococcal Infections - epidemiology / Staphylococcal Infections - microbiology / Staphylococcus aureus / Staphylococcus infections / Teicoplanin / Tertiary Care Centers - statistics & numerical data / Vancomycin / Virulence factors / Virulence Factors - genetics / Virulence Factors - isolation & purification