High prevalence of toxic shock syndrome toxin–producing epidemic methicillin-resistant Staphylococcus aureus 15 (EMRSA-15) strains in Kuwait hospitals

Abstract

This study characterized EMRSA-15 isolates obtained from patients in Kuwait hospitals for their genotypic relatedness, antibiotic resistance and carriage of virulence genes using pulsed-field gel electrophoresis (PFGE), coagulase serotyping, SCCmec subtyping, spa typing, multilocus sequence typing and DNA microarray. The isolates were resistant to trimethoprim (75.6%), ciprofloxacin (29.7%), erythromycin and clindamycin (24.3%), tetracycline (19.0%), and gentamicin and kanamycin (21.6%). All 37 isolates belonged to sequence type (ST) 22, coagulase type XI, three PFGE types and eight subtypes, ten spa types including t223 (51.3%), t852 (13.5%), t032 (8.1%), t790 (8.1%), t3107 (5.4%) and one each of t309, t2251, t3935, t5708 and t5983. Twenty-six isolates (70.2%) carried SCCmec IVa, eight isolates carried SCCmec IV and three isolates carried SCCmec IVh. All isolates carried agr1, cap5 and egc gene cluster (seg, sei, selm, seln, selo, and selu). tst (toxic shock syndrome toxin) was detected in 23 isolates. Eight isolates (21.6%) were positive for Panton-Valentine leukocidin (PVL). Genotypic analysis revealed that 62.1% of the isolates comprising ST22-IVa-t223 (51.3%) and ST22-IVa-t309/t2251/t3935/t5708 (10.8%) were CC22-[tst1+] UK EMRSA-15/Middle Eastern variant, 21.6% were CC22-PVL+ EMRSA-15 variant and 16.2% were CC22-UK EMRSA-15/Barnim clone. These results show that the tst1 positive-ST22-IVa-t223 (Middle Eastern variant) and the CC22-PVL+ EMRSA-15 variant were the dominant EMRSA-15 variants in Kuwait hospitals.

Antimicrobial susceptibility, virulence genes, and randomly amplified polymorphic DNA analysis of Staphylococcus aureus recovered from bovine mastitis in Ningxia, China

“…Toxic shock syndrome toxin 1 (tsst-1), a superantigen secreted by Staph. aureus in susceptible hosts, was responsible for toxic shock syndrome in humans (Kulhankova et al, 2014;Udo et al, 2016;Zarei Koosha et al, 2016). Currently, we found that 40% of Staph.…”

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

“…Secondly, the ST239-III-t860 isolates, obtained only in 2007, did not persist in the Maternity hospital in contrast to their persistence in other hospitals in Kuwait [33, 35]. Most of the ST22-IVa-t223 isolates were obtained from samples of skin and soft tissue infections as well colonization sites as was the case in other hospitals in Kuwait [36] supporting their ability to be involved in different types of infections. In contrast, the UK-EMRSA-15/Barnim epidemic MRSA clone is mostly associated with bloodstream infections [37].…”

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.…”