Molecular characterization of methicillin-resistant Staphylococcus aureus in nosocomial infections in a tertiary-care facility: emergence of new clonal complexes in Saudi Arabia

Senok, Abiola; Ehricht, Ralf; Monecke, Stefan; Al-Saedan, R.; Somily, Ali M.

doi:10.1016/j.nmni.2016.07.009

Cited by 50 publications

(78 citation statements)

References 29 publications

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“…CC22 MRSA are extremely common in Western Europe, but the rook isolates were not identical to the ubiquitous Barnim/UK-EMRSA-15 epidemic strain differing in SCC mec subtype (IVc rather than IVh; [77]) and presence of PVL genes. They were identical to a strain observed in several Middle Eastern countries and people with Middle Eastern travel history [109,127,128,129,130]. …”

Section: Resultssupporting

confidence: 72%

Diversity of Staphylococcus aureus Isolates in European Wildlife

et al. 2016

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Staphylococcus aureus is a well-known colonizer and cause of infection among animals and it has been described from numerous domestic and wild animal species. The aim of the present study was to investigate the molecular epidemiology of S. aureus in a convenience sample of European wildlife and to review what previously has been observed in the subject field. 124 S. aureus isolates were collected from wildlife in Germany, Austria and Sweden; they were characterized by DNA microarray hybridization and, for isolates with novel hybridization patterns, by multilocus sequence typing (MLST). The isolates were assigned to 29 clonal complexes and singleton sequence types (CC1, CC5, CC6, CC7, CC8, CC9, CC12, CC15, CC22, CC25, CC30, CC49, CC59, CC88, CC97, CC130, CC133, CC398, ST425, CC599, CC692, CC707, ST890, CC1956, ST2425, CC2671, ST2691, CC2767 and ST2963), some of which (ST2425, ST2691, ST2963) were not described previously. Resistance rates in wildlife strains were rather low and mecA-MRSA isolates were rare (n = 6). mecC-MRSA (n = 8) were identified from a fox, a fallow deer, hares and hedgehogs. The common cattle-associated lineages CC479 and CC705 were not detected in wildlife in the present study while, in contrast, a third common cattle lineage, CC97, was found to be common among cervids. No Staphylococcus argenteus or Staphylococcus schweitzeri-like isolates were found. Systematic studies are required to monitor the possible transmission of human- and livestock-associated S. aureus/MRSA to wildlife and vice versa as well as the possible transmission, by unprotected contact to animals. The prevalence of S. aureus/MRSA in wildlife as well as its population structures in different wildlife host species warrants further investigation.

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Section: Resultssupporting

confidence: 72%

Diversity of Staphylococcus aureus Isolates in European Wildlife

et al. 2016

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“…A very similar element has also been found by microarray hybridization in CC97-MRSA from Saudi Arabia 13. Furthermore, reports from Saudi Arabia have described MRSA isolates from other lineages that also harbored SCC fus in addition to SCC mec IV or V elements 6,13. Insertion elements flanked by 2 antiparallel copies of a transposase are common in bacteria, and often found in association with antibiotic resistance genes.…”

Section: Discussionsupporting

confidence: 55%

“…Two isolates (RUH-2 and RUH-71) were from patients with sepsis and wound infection, respectively, while the other 2 (RUH-98 and RUH-99) were from retail camel meat. S. aureus identification and confirmation of methicillin resistance was performed as previously described 6,7. Genomic DNA was extracted using Qiagen DNA isolation kit (Qiagen, Hilden, Germany) in accordance with manufacturer’s instructions.…”

Section: Methodsmentioning

confidence: 99%

“…While whole genome sequencing data are available for CC15-MSSA, there are, to the best of our knowledge, no publications on the genomic data for the rare CC15-MRSA. Recently, we reported the first identification of CC15-MRSA from clinical infections and retail meat products in the Middle East 6,7. In light of the emergence of CC15-MRSA in our setting and to provide much-needed insight into the genetic make-up of this rare MRSA clone, we have carried out whole genome sequencing of these isolates.…”

Section: Introductionmentioning

confidence: 99%

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Investigating a rare methicillin-resistant <em>Staphylococcus aureus</em> strain: first description of genome sequencing and molecular characterization of CC15-MRSA

Senok¹,

Somily²,

Slickers³

et al. 2017

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PurposeMethicillin resistant Staphylococcus aureus CC15 strains (CC15-MRSA) have only been sporadically described in literature. This study was carried out to describe the genetic make-up for this rare MRSA strain.MethodsFour CC15-MRSA isolates collected in Riyadh, Saudi Arabia, between 2013 and 2014 were studied. Two isolates were from clinical infection and 2 from retail meat products. Whole genome sequencing was carried out using Illumina HiSeq2500 genome analyzer.ResultsAll the CC15-MRSA isolates had the multilocus sequence typing profile ST1535, 13–13-1–1-81-11-13, which is a single locus variant of ST15. Of the 6 contigs related to the SCC element, one comprised a recombinase gene ccrAA, ccrC-PM1, fusC and a helicase, another one included mvaS, dru, mecA and 1 had yobV and Q4LAG7. The SCC element had 5 transposase genes, namely 3 identical paralogs of tnpIS431 and 2 identical paralogs of tnpIS256. Two identical copies of a tnpIS256-based insertion element flank the aacA-aphD gene. Two copies of this insertion element were present with 1 located in the SCC element and another inserted into the sasC gene. A short 3 kb region, which lacks any bacteriophage structural genes and site-specific DNA integrase, was inserted into the hlb gene. The hsdM and the 5’-part of the hsdS gene are replaced by a copy of the hsdM/hsdS paralogs from νSaβ giving rise to a new chimeric paralog of hsdS in νSaα.ConclusionCC15-MRSA shows a novel SCCmecV/SCCfus composite element. Its variant of hsdM/hsdS probably facilitated uptake of foreign mobile genetic elements that promoted emergence of CC15-MRSA. Close surveillance is needed to monitor spread and emergence of further CC15 MRSA strains.

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“…Methicillin resistant S. aureus (MRSA) is a major cause of nosocomial infections with significant morbidity and mortality globally [2]. Increasingly, community acquired MRSA lineages (CA-MRSA) are now being identified as the dominant aetiological agents of nosocomial MRSA infections [3][4][5]. High prevalence of MRSA colonization in HCWs in Saudi Arabia has been documented in the literature although detailed molecular characterization is lacking [6].…”

Section: Introductionmentioning

confidence: 99%