The Dissemination and Molecular Characterization of Clonal Complex 361 (CC361) Methicillin-Resistant Staphylococcus aureus (MRSA) in Kuwait Hospitals

Methicillin-resistant Staphylococcus aureus (MRSA) belonging to clonal complex 361 (CC361-MRSA) is rare among patients’ populations globally. However, CC361-MRSA has been isolated with an increasing trend among patients in Kuwait hospitals since 2010. This study investigated the molecular characteri...

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Main Authors: Eiman Sarkhoo, Edet E. Udo, Samar S. Boswihi, Stefan Monecke, Elke Mueller, Ralf Ehricht
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-05-01
Series:Frontiers in Microbiology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmicb.2021.658772/full
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spelling doaj-53a1736abef647db8b262994fa4200802021-05-07T01:01:28ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2021-05-011210.3389/fmicb.2021.658772658772The Dissemination and Molecular Characterization of Clonal Complex 361 (CC361) Methicillin-Resistant Staphylococcus aureus (MRSA) in Kuwait HospitalsEiman Sarkhoo0Edet E. Udo1Samar S. Boswihi2Stefan Monecke3Stefan Monecke4Elke Mueller5Elke Mueller6Ralf Ehricht7Ralf Ehricht8Ralf Ehricht9Faculty of Medicine, Department of Microbiology, Kuwait University, Kuwait City, KuwaitFaculty of Medicine, Department of Microbiology, Kuwait University, Kuwait City, KuwaitFaculty of Medicine, Department of Microbiology, Kuwait University, Kuwait City, KuwaitLeibniz Institute of Photonic Technology (IPHT), Jena, GermanyInfectoGnostics Research Campus Jena, Jena, GermanyLeibniz Institute of Photonic Technology (IPHT), Jena, GermanyInfectoGnostics Research Campus Jena, Jena, GermanyLeibniz Institute of Photonic Technology (IPHT), Jena, GermanyInfectoGnostics Research Campus Jena, Jena, GermanyInstitute of Physical Chemistry, Friedrich Schiller University Jena, Jena, GermanyMethicillin-resistant Staphylococcus aureus (MRSA) belonging to clonal complex 361 (CC361-MRSA) is rare among patients’ populations globally. However, CC361-MRSA has been isolated with an increasing trend among patients in Kuwait hospitals since 2010. This study investigated the molecular characteristics of CC361-MRSA isolated from patients in Kuwait hospitals in 2016–2018 to understand their genetic relatedness and virulence determinants. Of 5,223 MRSA isolates investigated by DNA microarray, 182 (3.4%) isolates obtained in 2016 (N = 55), 2017 (N = 56), and 2018 (N = 71) were identified as CC361-MRSA. The CC361-MRSA isolates were analyzed further using antibiogram, spa typing and multi locus sequence typing (MLST). Most of the isolates were resistant to fusidic acid (64.8%), kanamycin (43.4%), erythromycin (36.3%), and clindamycin (14.3%) encoded by fusC, aphA3, and erm(B)/erm(C) respectively. Nine isolates (4.9%) were resistant to linezolid mediated by cfr. The isolates belonged to 22 spa types with t3841 (N = 113), t315 (N = 16), t1309 (N = 14), and t3175 (N = 5) constituting 81.3% of the spa types, four genotypes (strain types), CC361-MRSA-[V/VT + fus] (N = 112), CC361-MRSA-IV, WA MRSA-29 (N = 36), CC361-MRSA-V, WA MRSA-70/110 (N = 33) and CC361-MRSA-[V + fus] variant (N = 1). MLST conducted on 69 representative isolates yielded two sequence types: ST361 (11/69) and ST672 (58/69). All CC361-MRSA isolates were positive for cap8, agr1, and the enterotoxin egc gene cluster (seg, sei, selm, seln, selo, and selu). The tst1 was detected in 19 isolates. The immune evasion cluster (IEC) genes type B (scn, chp, and sak) and type E (scn and sak) were detected in 20 and 152 isolates, respectively. The CC361-MRSA circulating in Kuwait hospitals consisted of two closely related sequence types, ST361 and ST672 with ST672-MRSA [V/VT + fus] as the dominant genotype. The dissemination of these newly emerged clones and the emergence of linezolid resistance limits therapeutic options, as well as present significant challenges for the control of MRSA infections in Kuwait hospitals.https://www.frontiersin.org/articles/10.3389/fmicb.2021.658772/fullCC361-MRSAmolecular typingDNA microarrayMLSTspa typing
collection DOAJ
language English
format Article
sources DOAJ
author Eiman Sarkhoo
Edet E. Udo
Samar S. Boswihi
Stefan Monecke
Stefan Monecke
Elke Mueller
Elke Mueller
Ralf Ehricht
Ralf Ehricht
Ralf Ehricht
spellingShingle Eiman Sarkhoo
Edet E. Udo
Samar S. Boswihi
Stefan Monecke
Stefan Monecke
Elke Mueller
Elke Mueller
Ralf Ehricht
Ralf Ehricht
Ralf Ehricht
The Dissemination and Molecular Characterization of Clonal Complex 361 (CC361) Methicillin-Resistant Staphylococcus aureus (MRSA) in Kuwait Hospitals
Frontiers in Microbiology
CC361-MRSA
molecular typing
DNA microarray
MLST
spa typing
author_facet Eiman Sarkhoo
Edet E. Udo
Samar S. Boswihi
Stefan Monecke
Stefan Monecke
Elke Mueller
Elke Mueller
Ralf Ehricht
Ralf Ehricht
Ralf Ehricht
author_sort Eiman Sarkhoo
title The Dissemination and Molecular Characterization of Clonal Complex 361 (CC361) Methicillin-Resistant Staphylococcus aureus (MRSA) in Kuwait Hospitals
title_short The Dissemination and Molecular Characterization of Clonal Complex 361 (CC361) Methicillin-Resistant Staphylococcus aureus (MRSA) in Kuwait Hospitals
title_full The Dissemination and Molecular Characterization of Clonal Complex 361 (CC361) Methicillin-Resistant Staphylococcus aureus (MRSA) in Kuwait Hospitals
title_fullStr The Dissemination and Molecular Characterization of Clonal Complex 361 (CC361) Methicillin-Resistant Staphylococcus aureus (MRSA) in Kuwait Hospitals
title_full_unstemmed The Dissemination and Molecular Characterization of Clonal Complex 361 (CC361) Methicillin-Resistant Staphylococcus aureus (MRSA) in Kuwait Hospitals
title_sort dissemination and molecular characterization of clonal complex 361 (cc361) methicillin-resistant staphylococcus aureus (mrsa) in kuwait hospitals
publisher Frontiers Media S.A.
series Frontiers in Microbiology
issn 1664-302X
publishDate 2021-05-01
description Methicillin-resistant Staphylococcus aureus (MRSA) belonging to clonal complex 361 (CC361-MRSA) is rare among patients’ populations globally. However, CC361-MRSA has been isolated with an increasing trend among patients in Kuwait hospitals since 2010. This study investigated the molecular characteristics of CC361-MRSA isolated from patients in Kuwait hospitals in 2016–2018 to understand their genetic relatedness and virulence determinants. Of 5,223 MRSA isolates investigated by DNA microarray, 182 (3.4%) isolates obtained in 2016 (N = 55), 2017 (N = 56), and 2018 (N = 71) were identified as CC361-MRSA. The CC361-MRSA isolates were analyzed further using antibiogram, spa typing and multi locus sequence typing (MLST). Most of the isolates were resistant to fusidic acid (64.8%), kanamycin (43.4%), erythromycin (36.3%), and clindamycin (14.3%) encoded by fusC, aphA3, and erm(B)/erm(C) respectively. Nine isolates (4.9%) were resistant to linezolid mediated by cfr. The isolates belonged to 22 spa types with t3841 (N = 113), t315 (N = 16), t1309 (N = 14), and t3175 (N = 5) constituting 81.3% of the spa types, four genotypes (strain types), CC361-MRSA-[V/VT + fus] (N = 112), CC361-MRSA-IV, WA MRSA-29 (N = 36), CC361-MRSA-V, WA MRSA-70/110 (N = 33) and CC361-MRSA-[V + fus] variant (N = 1). MLST conducted on 69 representative isolates yielded two sequence types: ST361 (11/69) and ST672 (58/69). All CC361-MRSA isolates were positive for cap8, agr1, and the enterotoxin egc gene cluster (seg, sei, selm, seln, selo, and selu). The tst1 was detected in 19 isolates. The immune evasion cluster (IEC) genes type B (scn, chp, and sak) and type E (scn and sak) were detected in 20 and 152 isolates, respectively. The CC361-MRSA circulating in Kuwait hospitals consisted of two closely related sequence types, ST361 and ST672 with ST672-MRSA [V/VT + fus] as the dominant genotype. The dissemination of these newly emerged clones and the emergence of linezolid resistance limits therapeutic options, as well as present significant challenges for the control of MRSA infections in Kuwait hospitals.
topic CC361-MRSA
molecular typing
DNA microarray
MLST
spa typing
url https://www.frontiersin.org/articles/10.3389/fmicb.2021.658772/full
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