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Title: Molecular Characterization of Methicillin-Resistant Staphylococcus aureus Isolated in Kuwait Hospitals
Authors: Samar S. S. Boswihi 
Supervisor: Dr. E. E. Udo
Keywords: MRSA;molecular typing;virulence determinants;PFGE;MLST
Issue Date: 2015
Publisher:  Kuwait university - college of graduate studies
Abstract: the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) is constantly changing globally, determining the prevailing MRSA clones in a local healthcare facility is important for better management of infections. This study investigated antibiotic resistance patterns, carriage of virulence factors, clonal composition and distribution of MRSA isolates in Kuwait’s hospitals using a combination of antibiogram and molecular typing methods. In total, 400 non-repeat MRSA isolates obtained between 1992 and 2010 in 13 public hospitals were characterized. The isolates were resistant to kanamycin (74.2%), erythromycin (69.5%), tetracycline (66.7%), gentamicin (61%), ciprofloxacin, (61%), fusidic acid (53.5%), clindamycin (41.5%), high-level mupirocin resistance (5.2%) and carried aphA3, aacA-aphD, ermA, ermC, mupA, tetK, tetM, fusC and far1. Molecular typing revealed 31 different MRSA clones consisting of ST239-MRSA-III (52.2%), ST22-MRSA-IV (9.2%), ST80-MRSA-IV (7.5%), ST5-MRSA-II/IV/V/VI (6.5%), ST30-MRSA-IV (3.5%), ST241-MRSA-III (2.7%), ST6-MRSA-IV (2.2%), ST36-MRSA-II (2%) and ST772-MRSA-V (2%). The isolates differed in the carriage of genes for enterotoxins, PVL, tst1, arginine catabolic mobile element (ACME) and exfoliate toxins. The number of clones increased from one (ST239-III-t037) in 1992 to 30 in 2010 including ST8-IV-t008 [PVL+] [ACME+] (USA300), ST772-V (Bengal Bay clone) and ST2816 identified for the first time in Kuwait. The study revealed that the MRSA isolates belonged to diverse clones that changed in numbers and diversity overtime. Although ST239-MRSA-III remained the dominant MRSA clone overtime, the newly emerged clones consisted mostly of CA-MRSA.
Appears in Programs:0520 Microbiology (Ph.D.)

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