The dissemination of ST80-SCCmec-IV community-associated methicillin resistant Staphylococcus aureus clone in Kuwait hospitals.
BACKGROUND
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is a global healthcare problem. The purpose of this study was to characterize CA-MRSA clones and their distribution in Kuwait hospitals.


METHODS
In total, 135 CA-MRSA isolates, carrying the SCCmec IV or V genetic elements, isolated in eight hospitals were characterized using antibiogram, pulsed-field gel electrophoresis, multilocus sequence typing, and carriage of genes for Panton-Valentine Leukocidin (PVL), capsular polysaccharides types (cap) 5 and 8, accessory genes regulators (agr), Staphylococcal enterotoxins (SE) and toxic shock syndrome toxin 1 (tst).


RESULTS
They were susceptible to vancomycin, teicoplanin and linezolid but resistant to kanamycin (62%), fusidic acid (42.2%), tetracycline (39.3%), erythromycin and clindamycin (21.5%), gentamicin (5.9%), streptomycin (6.7%), trimethoprim (5.9%), mupirocin (6.6%) and cadmium acetate (82.2%). They consisted of 10 pulsotypes with the majority belonging to PFGE type I (51.1%), type II (22.2%), type IV (13.3%) and type III (3.7%). They belonged to 10 sequence types (ST) comprising ST80 (51.1%), ST30 (22.2%), ST5 (14.1%), ST1 (4.45), ST6 (3.7%), ST88 (1.5%), ST834 (1.5%), ST8 (0.7%), ST46 (0.7%) and ST950 (0.7%). Genes for PVL, cap 8, cap 5 and agr III, agr I and agr II were detected in 61.5%, 77.3%, 20.7% and 62.2%, 17% and 8.1% of the isolates respectively. Nine (6.7%) isolates contained tst while 103 isolates were positive for SE genes with sei (63.0%), seg (41.5%) and sed (29.6%) as the common SE genes.


CONCLUSIONS
ST80-SCCmecIV was the most common CA-MRSA clone in Kuwait hospitals presenting new challenges for infection control.
Department of Microbiology, Kuwait University, Kuwait. EDET@hsc.edu.kw
Edet E
EE
Udo
Eiman
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Sarkhoo
D001426:Bacterial Proteins / Q000235:genetics; D015373:Bacterial Typing Techniques; D016000:Cluster Analysis; D017714:Community-Acquired Infections / Q000382:microbiology*; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D005798:Genes, Bacterial; D005838:Genotype; D006761:Hospitals; D006801:Humans; D007730:Kuwait / Q000453:epidemiology; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D058885:Multilocus Sequence Typing; D011135:Polysaccharides, Bacterial / Q000235:genetics; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D037521:Virulence Factors / Q000235:genetics
D001426:Bacterial Proteins; D004269:DNA, Bacterial; D011135:Polysaccharides, Bacterial; D037521:Virulence Factors