Characterisation of non-multiresistant methicillin-resistant Staphylococcus aureus (including EMRSA-15) in Kuwait Hospitals

Abstract

This study characterised non-multiresistant methicillin-resistant Staphylococcus aureus (nmMRSA) isolates from Kuwait hospitals to ascertain whether they were community-acquired MRSA (CA-MRSA). Forty-two nmMRSA isolates obtained between July 2001 and October 2003 were analysed by staphylococcal cassette chromosome mec (SCCmec) typing, bacteriophage typing, production of Panton-Valentine leukocidin (PVL), urease and staphylococcal enterotoxins A, B, C and D, TSST-1, and by pulsed-field gel electrophoresis (PFGE). Forty-one isolates were SCCmec type IV, and one isolate was SCCmec type III. The isolates belonged to six PFGE patterns, with two types, A and D, distributed in six and four hospitals, respectively. Most (n = 26; 61.9%) isolates produced urease. These isolates were mainly from wound and skin infections, showed low-level methicillin resistance (MIC 8-48 mg/L), and nine carried genes for PVL. These characteristics, together with their carriage of the type-IV SCCmec, identified the isolates as CA-MRSA. Ten of the 16 urease-negative isolates produced staphylococal enterotoxin C; 12 reacted weakly with phage 75, and were resistant to clindamycin and/or erythromycin, which are characteristics of EMRSA-15. Thus, this study identified the co-existence of two types of nmMRSA, i.e., CA-MRSA and EMRSA-15, in Kuwait hospitals.

Transcriptional profiling of a Staphylococcus aureus clinical isolate and its isogenic agr and sarA mutants reveals global differences in comparison to the laboratory strain RN6390

“…The results of this comparison confirmed that the UAMS isolates are closely related to each other and to (Cassat et al, 2005), which is a prominent clinical isolate found in diverse geographical areas worldwide (Aires de Sousa et al, 2005;Johnson et al, 2005;Nimmo et al, 2006;Udo et al, 2006). Our analysis also confirmed that the cluster containing UAMS-1, UAMS-601 and EMRSA-16 is the most distantly related, among the strains we examined, to the prototype laboratory strains NCTC 8325 and RN6390 (Cassat et al, 2005).…”

Changes in the Clonal Nature and Antibiotic Resistance Profiles of Methicillin-Resistant Staphylococcus aureus Isolates Associated with Spread of the EMRSA-15 Clone in a Tertiary Care Portuguese Hospital

“…The EMRSA-15 clone is one of the pandemic MRSA clones (18) and has been identified in several countries such as The Netherlands (18,62), Denmark (21), Germany (63), Ireland and Sweden (18), the Czech Republic (32, 33), Australia and New Zealand (23,46), Kuwait (59), and Spain (6,35,47).…”

Genetic Lineages of Community-Associated Methicillin-Resistant Staphylococcus aureus in Kuwait Hospitals

“…CAMRSA strains are characterized by their susceptibility to a wide range of non-beta-lactam antibiotics, low methicillin MICs, and the carriage of the type IV or V staphylococcal cassette chromosome mec (SCCmec) element. In contrast health care-associated MRSA strains are usually multiresistant to non-beta-lactam antibiotics and contain type I, II, or III SCCmec elements (1,13).…”

“…CAMRSA isolates obtained in Kuwait hospitals were previously characterized by antibiotic resistance patterns and SCCmec typing (13), but their sequence types were not determined. Consequently, it was not possible to ascertain whether the CAMRSA strains isolated in Kuwait hospitals constituted indigenous or imported internationally recognized clones.…”

“…1). Their susceptibility to antibiotics and SCCmec types were described previously (13). The fusidic acid-resistant isolates were investigated for the carriage of the fusidic acid resistance determinant far-1 by PCR as described previously (15), and fusidic acid MICs were determined using the Etest.…”