Predominance of ST22-MRSA-IV Clone and Emergence of Clones for Methicillin-Resistant <i>Staphylococcus aureus</i> Clinical Isolates Collected from a Tertiary Teaching Hospital Over a Two-Year Period

Abstract

INTRODUCTION Methicillin-resistant Staphylococcus aureus (MRSA) is an established nosocomial pathogen that causes infections, such as bacteremia, respiratory tract infections, skin and soft tissue infections (SSTIs), bone and joint infections, and urinary tract infections (1, 2). The prevalence rate of hospital-acquired MRSA infections was the highest (＞50) in Asia, South America, and Malta, followed by lower prevalence rates (25-50) in Australia, China, Africa, Romania, Greece, Italy, and Portugal (3). The prevalence rate of MRSA in Malaysia has been reported to increase from 17 in 1986 (4) to 44 in 2007 (5). To date, healthcare-associated MRSA (HA-MRSA) remains a global healthcare concern; however, the emergence of community-associated MRSA (CA-MRSA) since the 1990s poses significant risks and threats to both hospital and community populations. The current modality of treatment for MRSA infections is prescribing antibiotics, such as vancomycin, linezolid, rifampicin, and fusidic acid (2,6). The molecular epidemiology of MRSA can be studied using different typing methods, such as staphylococcal cassette chromosomal mec (SCCmec) typing, multilocus sequence typing (MLST), and pulsed

Diversity of clonal complex 22 methicillin-resistant Staphylococcus aureus isolates in Kuwait hospitals

“…The population of CC22-MRSA isolates increased from 195 isolates in 2016 to 214 in 2018 compared with the 37 isolates that was collected in 2010 ( Udo et al, 2016 ). The observed expansion in the proportion of CC22-MRSA isolates in Kuwait hospitals mimics reports from some Asian and European countries where the numbers of CC22-MRSA isolates are also high ( Marchese et al, 2009 ; Conceição et al, 2013 ; Sunagar et al, 2016 ; Niek et al, 2019 ). Similarly, recent studies in China reported increase in the population of ST22-MRSA isolates among patients suffering from skin and soft tissue infections ( Zhao et al, 2012 ; Xiao et al, 2019 ).…”

Methicillin-Resistant Staphylococcus aureus (MRSA) Clonal Replacement in a Malaysian Teaching Hospital: Findings from an Eight-Year Interval Molecular Surveillance

“…Comparatively, there were fewer second phase surveillance studies of Malaysian MRSA strains (for strains isolated after 2012) [12,29]. Nonetheless, like our findings, two other studies of this phase also noted the higher prevalence of SCCmec type IV compared to other SCCmec types.…”

“…Indeed, surveillance on MRSA antibiotic susceptibility is routinely carried out and reported in Malaysia by the Ministry of Health, in conjunction with Malaysia's Malaysian National Surveillance on Antimicrobial Resistance (NSAR) and the country's conformance to WHO's Global Antimicrobial Resistance Surveillance System (GLASS) initiative [10,11]. In addition, a few Malaysian hospitals have also conducted molecular surveillance on local MRSA strains [12][13][14][15][16].…”

Molecular characterization of methicillin-resistant Staphylococcus aureus clinical strains from the endotracheal tubes of patients with nosocomial pneumonia

“…The molecular epidemiology of MRSA in bloodstream infections has been described previously, but less frequently in respiratory infections contracted in the ICU [27,28]. CC22 is one of the largest circulating clonal complexes associated with hospital-acquired MRSA in Europe (UK) and Asia (Kuala Lumpur, China) [11,29], while studies of nosocomial pneumonia indicate that CC5 is associated with MRSA strains originating mostly from the US, Europe (Portugal), Asia (China), Africa (Algeria) and Latin America (Argentina and Chile) [18,19,30,31]. Despite the marked heterogeneity of the sequence types in this study, CC22 and CC5 were the main clonal complexes detected.…”