Genotyping of Staphylococcus aureus associated with nasal colonization among healthcare workers using DNA microarray

Senok, Abiola; Somily, Ali M.; Raji, Muhabat Adeola; Garaween, Ghada; Kabil, Maha M.; Shibl, Atef M.; Monecke, Stefan; Ehricht, Ralf

doi:10.3855/jidc.10328

Cited by 10 publications

(5 citation statements)

References 21 publications

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“…We had previously reported CC1153-MSSA as nasal colonizer in health care workers at KKUH but this is the first identification of CC1153-MRSA in this facility 9. In our region, the two CC1153-MRSA isolates reported have been from Kuwait 5,20.…”

Section: Discussionmentioning

confidence: 71%

“…Recently reported work showed the presence of a high degree of diversity and an emergence of both pandemic and rare MRSA strains among isolates obtained from 2009 to 2015 at King Khaled University Hospital (KKUH), Riyadh, Saudi Arabia 8. Further work also showed that MRSA colonizing health care workers at the facility were of similar population structure as those identified in patients 9…”

Section: Introductionmentioning

confidence: 96%

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Emergence of novel methicillin-resistant Staphylococcus aureus strains in a tertiary care facility in Riyadh, Saudi Arabia

Senok¹,

Somily²,

Nassar³

et al. 2019

IDR

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Purpose There is a need for continuous surveillance of methicillin-resistant Staphylococcus aureus (MRSA) to identify emergence of new strains. We hypothesize that MRSA strains are evolving with ongoing acquisition of SCC mec elements. This study was carried out to evaluate the evolution of MRSA at a tertiary care facility in Saudi Arabia. Methods MRSA isolates associated with invasive clinical infection, which were identified in 2017 at the microbiology laboratory, King Khalid University Hospital (KKUH) in Riyadh, Saudi Arabia, were studied. The molecular characterization of isolates was carried out using StaphyType DNA microarray (Alere Technologies GmbH/Abbott, Jena, Germany). Results The 125 MRSA isolates studied belonged to 18 clonal complexes (CC) which were distributed into 32 strain assignments. The predominant CC were CC5 (n=30), CC6 (n=17), CC80 (n=13), CC22 (n=12), CC361 (n=12). The findings demonstrated the first identification of CC152, CC361 and CC1153 MRSA as well as ST5-MRSA-[I+fus], “Geraldine Clone”, CC6-MRSA-IV (PVL+) and CC88-MRSA-V (PVL+), WA MRSA-117 in Saudi Arabia. Four novel variants were identified: CC5-MRSA-[VI+fus+tirS], CC22-MRSA-[V/VT+fus](PVL+), CC152-MRSA-[V+fus](PVL+) and CC361-MRSA-[VT+fus]. Fifty-four isolates (n/N=54/125; 43.2%) including the novel strains carried the Q6GD50 SCC fusC gene while the Panton-Valentine leukocidin genes were present in 30.4% (n/N=38/125). Conclusion The findings demonstrate an expanding MRSA repertoire in our setting including emergence of previously unreported clonal complexes and novel strains. The high carriage of fusC gene suggests a role for fusidic acid misuse in driving the evolution of the MRSA genome and underscores the need for increased monitoring of antibiotic use.

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 96%

Emergence of novel methicillin-resistant Staphylococcus aureus strains in a tertiary care facility in Riyadh, Saudi Arabia

Senok¹,

Somily²,

Nassar³

et al. 2019

IDR

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“…In the UAE, novel variants of this MRSA strain and putative PVL-deletion mutants have been reported ( Senok et al., 2020a ). For CC15-MRSA-[V+ fusC ] the ancestral CC15-MSSA is a common nasal colonizer in the Middle East ( Sarkar et al., 2016 ; Senok et al., 2018 ). However, in recent years, CC15-MRSA has emerged among humans and livestock (camels) in the UAE, Kuwait and Saudi Arabia ( Raji et al., 2016 ; Senok et al., 2017 ; Boswihi et al., 2018 ; Senok et al., 2020a ).…”

Section: Discussionmentioning

confidence: 99%

Lateral Flow Immunoassay for the Detection of Panton-Valentine Leukocidin in Staphylococcus aureus From Skin and Soft Tissue Infections in the United Arab Emirates

Senok

Monecke

Nassar

et al. 2021

Front. Cell. Infect. Microbiol.

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IntroductionPanton Valentine leukocidin (PVL) is a virulence factor which is associated with methicillin sensitive and resistant Staphylococcus aureus (MSSA/MRSA) causing skin and soft tissue infections (SSTI). This study aimed to evaluate a novel lateral flow immunoassay (LFI) for PVL detection in S. aureus cultures and to describe their genotypic characterization.MethodsThe study was carried out from January-August 2020 in Dubai, United Arab Emirates. S. aureus isolates associated with SSTI were tested for PVL detection using LFI. DNA microarray-based assays were used for molecular characterization including detection of pvl genes.ResultsOne-hundred thirty-five patients with a clinical diagnosis of SSTIs were recruited. Sixty-six patients received antibiotics, mostly beta lactams (n=36) and topical fusidic acid (n=15). One-hundred twenty-nine isolates (MRSA: n=43; MSSA: n=86) were tested by LFI and DNA microarrays. All 76 (58.9%) isolates which were unambiguously negative for the PVL in LFI were negative for pvl genes using the DNA microarray. All the LFI PVL positive isolates (n=53) had pvl genes detected. This translates into 100% each for sensitivity, specificity, positive and negative predictive values for the LFI. The LFI typically takes about 15 min inclusive of a 10 min incubation period. Predominant S. aureus clonal complexes (CC) were CC30 (n=18), CC22 (n=13), CC5 (n=12), CC1 (n=11), CC152 (n=8), CC15 (n=7); CC97 (n=7); CC8 and CC20 (n=6 each). Among MRSA, the proportion of pvl-positives (35/43; 81%) was higher than among MSSA (n/N=18/86; 21%). The fusidic acid resistance gene fusC was detected in 14 MRSA (33%) compared to 8 MSSA (9%). A co-carriage of fusC and pvl genes was present in 7 MRSA and in one MSSA.ConclusionLFI shows excellent diagnostic accuracy indices for rapid identification of PVL in MSSA/MRSA in a setting with high prevalence of pvl+ve strains. The high occurrence of pvl and fusC genes in MRSA strains causing SSTI is of concern and needs constant surveillance.

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“…(23.5%)[44,50,106,109,111,115,127,129,143,160,170,174] (29.4%)[50,53,54,61,63,64,73,85,101,102,118,126,131,132,147] …”

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confidence: 99%

Antimicrobial resistance among GLASS pathogens in conflict and non-conflict affected settings in the Middle East: a systematic review

Truppa

Abo‐Shehada

2020

BMC Infect Dis

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Background In spite of the evident general negative effects of armed conflict on countries’ health systems and populations’ health outcomes, little is known about similar impacts of conflicts on the spread of antimicrobial resistances (AMR). This review was to address this evidence gap and describe: Patterns of AMR in the Middle East (ME) and resistance profiles of pathogens included in the Global AMR Surveillance System (GLASS) supported by the World Health Organization; Differences in proportions of AMR isolates between conflict and non-conflict countries. Methods A systematic literature review was conducted following PRISMA guidelines and searching five electronic databases. Subject heading and free text were searched for “antimicrobial resistances” and “Middle East”, to identify observational studies on AMR published from January 2011 to June 2018. Data were extracted from included articles on a predefined set of variables. Percentages of AMR were analysed as median and interquartile ranges. Risk of bias was assessed using the Newcastle-Ottawa Scale. Results A total of 132 articles met the inclusion criteria. Included studies showed heterogeneity in study design, laboratory methods and standards for interpretation of results, and an overall high risk of bias. Main findings were the following: High proportions of carbapenem resistance in Acinetobacter spp. (median 74.2%), and both carbapenem resistance (median 8.1 and 15.4% for E. coli and K. pneumoniae respectively) and ESBL-production (median 32.3 and 27.9% for E. coli and K. pneumoniae respectively) amongst Enterobacteriaceae. S. aureus isolates showed a median methicillin resistance percentage of 45.1%, while vancomycin resistance was almost absent. A median of 50% of the strains of S. pneumoniae showed non-susceptibility to penicillin. Similar trends were observed in conflict and non-conflict affected countries. Conclusions There is a lack of standardization in the methodological approach to AMR research in the Middle East. The proportion of antibiotic resistances among specific GLASS pathogens is high, particularly among Acinetobacter spp.

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Genotyping of Staphylococcus aureus associated with nasal colonization among healthcare workers using DNA microarray

Cited by 10 publications

References 21 publications

<p>Emergence of novel methicillin-resistant <em>Staphylococcus aureus</em> strains in a tertiary care facility in Riyadh, Saudi Arabia</p>

<p>Emergence of novel methicillin-resistant <em>Staphylococcus aureus</em> strains in a tertiary care facility in Riyadh, Saudi Arabia</p>

Lateral Flow Immunoassay for the Detection of Panton-Valentine Leukocidin in Staphylococcus aureus From Skin and Soft Tissue Infections in the United Arab Emirates

Antimicrobial resistance among GLASS pathogens in conflict and non-conflict affected settings in the Middle East: a systematic review

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