Antibiotic Resistance Trends in Methicillin-Resistant Staphylococcus aureus Isolated in Kuwait Hospitals: 2011-2015

Abstract

Objective: The aim of this study was to determine antibiotic resistance trends and carriage of staphylococcal cassette chromosome mec (SCCmec) genetic elements in methicillin-resistant Staphylococcus aureus (MRSA) isolated in Kuwait hospitals to ascertain whether they were healthcare associated (HA-MRSA) or community associated (CA-MRSA). Materials and Methods: In total, 6,922 MRSA isolates obtained from different clinical samples were tested for resistance toantibiotics, urease production, and carriage of SCCmec elements. Results: All MRSA isolates were susceptible to linezolid, vancomycin, and teicoplanin. However, some isolates were resistant to kanamycin (2,979; 43%), ciprofloxacin (2,955; 42.7%), erythromycin and clindamycin (2,935; 42.4%), fusidic acid (2,858; 41.2%), gentamicin (2,665; 38.5%), tetracycline (2,652; 38.3%), and trimethoprim (2,324; 33.5%). Whereas the prevalence of resistance to most antibiotics showed annual variations, those resistant to chloramphenicol and rifampicin increased from 2.6 and 0.1% to 9.6 and 1.6%, respectively, and high-level mupirocin resistance declined from 9.3% in 2011 to 3.6% in 2015. In total, 3,244 (53.9%) of the isolates carried SCCmec IV followed by SCCmec III (1,737; 28.8%) and SCCmec V (890; 14.8%). SCCmec I (21; 0.3%) and II (79; 0.8%) occurred sporadically. A total of 3,651 (60.7%) of the isolates belonged to the CA-MRSA genotype and 2,290 isolates (38.1%) were identified as HA-MRSA. Conclusion: This study demonstrates changes in antibiotic resistance patterns of MRSA over time and reinforces the value of surveillance in detecting such changes for the benefit of infection control and patient management.

Antibiotic resistance and typing of the methicillin-resistant Staphylococcus aureus clones in Kuwait hospitals, 2016–2017

“…Significantly, the prevalence of high-level mupirocin resistance decreased from 3.7% in 2016 to 2.4% in 2017. This is consistent with previous report of low prevalence of high-level mupirocin resistance in Kuwait hospitals in recent years [9]. This is reassuring because it indicates that mupirocin can still be used successfully to control MRSA infections.…”

Streptomyces as a Prominent Resource of Future Anti-MRSA Drugs

“…Currently, 2 out of 100 people are carriers of CA-MRSA (CDC, 2016 ); which is particularly worrying as CA-MRSA can more easily spread than HA-MRSA. It has been suggested that there may be a more mobile genetic element in CA-MRSA as compared to HA-MRSA (Udo and Boswihi, 2017 ; Boswihi and Udo, 2018 ). According to CDC, a CA-MRSA is categorized as such if infection is evident on admission or a MRSA culture was obtained within 48 h of admission, with no history of admissions or medical treatment requiring invasive procedures (Gorwitz et al, 2006 ).…”

Study of the virulence factors and antimicrobial susceptibility profile of staphylococcus aureus isolated from clinical samples at tertiary care centre

“…It wasthen followed by tetracycline having a mean susceptibility of 95%; while penicillin G was ineffective with 94 cases having 0% susceptibility [18]. Whereas the prevalence of resistance to most antibiotics showed annual variations, those resistant to chloramphenicol and rifampicin increased from 2.6 and 0.1% to 9.6 and 1.6%, respectively, and high-level mupirocin resistance declined from 9.3% in 2011 to 3.6% in 2015 [19].…”