Dominance of community-associated methicillin-resistant Staphylococcus aureus clones in a maternity hospital

Abstract

BackgroundMethicillin- resistant Staphylococcus aureus (MRSA) is a major pathogen causing healthcare- and community- acquired infections. The purpose of this study was to characterize MRSA isolated at the Maternity Hospital between 2006 and 2011 for their genetic relatedness.Materials and methodsThe MRSA isolates were investigated using a combination of antibiogram, Staphylococcal chromosome cassette mec (SCCmec) and spa typing to determine their relatedness to MRSA isolated in other Kuwait hospitals. The isolates were also investigated for the carriage of genes for Pantone valentine Leukocidin (PVL).ResultsA total of 103 MRSA obtained from 64 neonates, 17 adult patients and 12 healthcare workers. The isolates were resistant to Kanamycin (46.6%), gentamicin (40.8%), trimethoprim (32%), ciprofloxacin (22.3%), fusidic acid (16.5%), tetracycline (19.4%), erythromycin (15.5%), clindamycin (15.5%), streptomycin (11.6%) high-level mupirocin (2.9%) and chloramphenicol (0.9%). Twenty (19.4%) of the isolates were multiresistant. Thirty-one (30.0%) isolates were positive for PVL. Molecular typing revealed the presence of 11 clonal complexes and 23 clones with ST5-V-t002, (N = 22), ST22-IV-t223 (N = 18), ST22-IV-t852 (N = 10), ST80-IV-t044 (N = 7), ST5-V-t688 (N = 5), ST772-V-t657 (N = 5) and ST239-III-t860 (N = 4) constituting 66.9% of the isolates. Other clones were isolated sporadically. The number of MRSA isolates increased from two in 2006 to 22 in 2011 with a peak of 43 in 2008.ConclusionThe study revealed a high prevalence of community-associated MRSA Maternity hospital. The MRSA population consisted of known strains, such as ST239-III-t680, ST22-IV-t223/t852 and ST80-IV-t044, that were reported previously in Kuwait and novel strains such as ST5-V-t002, and several sporadic strains obtained for the first time in the Maternity hospital. This study has provided an initial data which will serve as a platform for future comparative studies on the distribution of MRSA clones in the Maternity hospital in Kuwait.

Molecular Typing of ST239-MRSA-III From Diverse Geographic Locations and the Evolution of the SCCmec III Element During Its Intercontinental Spread

“…In Kuwait, CC239-MRSA-III accounted for more than 50% of typed MRSA isolates collected in a period from 1992 to 2010 (Boswihi et al, 2016 ). Currently, it is still present although it appears to be replaced by community-acquired MRSA strains (Udo and Al-Sweih, 2017 ).…”

Methicillin-Resistant Staphylococcus aureus ST80 Clone: A Systematic Review

“…Recent studies reported the local predominance of this clone in many countries including European countries [143,144], the Middle East, Asia, and South America [145]. Another epidemic clone, MRSA-ST22, has been predominately identified in recent years throughout the Middle East [44,45,[146][147][148][149][150][151][152][153][154], Europe [155][156][157][158][159][160], and Asia [161][162][163]. For North Africa, the lower number of studies on MRSA means that MRSA lineages remained unclear.…”

“…Of the total MRSA strains, MRSA-ST80 prevalence was 3% (3/102) in Turkey [38], 4% (3/79) in Oman [39], 10% (2/21) in Egypt [40], 19% (10/52) in United Arab Emirates [41], and 31% (37/121) in Palestine [42]. In Kuwait, the reported proportions of MRSA-ST80 among MRSA strains were 38.4% (10/26) [45]. In Jordan, MRSA-ST80 strains were detected in 34.1% (14/41) of all MRSA strains recovered from infections from 2009 to 2010 [46].…”

Differences in resistance profiles and virulence genes among methicillin-resistant and methicillin-susceptible Staphylococcus aureus of different lineages at a public tertiary hospital

“…The dynamics of the prevalence of S. aureus clones, including MRSA and MSSA strains, have been recently investigated 6 . As a consequence, the changes in the epidemiological overview have been observed worldwide, revealing the emergence of new clones replacing the previously established ones 7,8 . As monitoring resistance and virulence profiles is important to establish control strategies, here we aimed to analyze and compare the antimicrobial resistance patterns, virulence profiles, and molecular epidemiology of S. aureus strains isolated from a public hospital located in south-eastern Brazil.…”