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Title: Molecular Typing of Methicillin Resistant Staphylococcus aureus (MRSA) Isolates with Reduced Sensitivity to Chlorhexidine in Kuwaiti Hospitals
Authors: Mashael Naji Al-Shemmari 
Supervisor: Dr. Leila Vali
Keywords: Polymerase chain reaction
Issue Date: 2017
Publisher:  Kuwait university - college of graduate studies
Abstract: Worldwide prevalence of MRSA infections has led to greater public awareness of the threat of nosocomial infections and there are increased efforts to control these infections using suitable hygienic measures. Biocides are considered as a crucial part of infection control strategies employed in the hospital. However, the emergence of antiseptic resistance genes has raised a concern. The aim of the study is to determine the biocidal resistance genes in methicillin resistant Staphylococcus aureus (MRSA) infected clinical specimens, found in Kuwait hospitals, and to identify whether the MRSA, with reduced sensitivity to antibiotics and biocides, are clonal. A total of 97 MRSA infected clinical specimens, were collected from nine hospitals in the years 2013 to 2014. Polymerase chain reaction method was used to amplify the genes; mecA, blaZ, qacA/B, qacH, qacG, smr and norA. The minimum inhibitory concentration test (MIC) and the minimum biocidal concentration test (MBC), of chlorhexidine, were determined for all isolates. In addition, an antibiotic sensitivity test, which included 10 antibiotics, were also determined for these isolates. Multi locus sequencing typing test (MLST) and pulsed-field gel electrophoresis (PFGE) were used to identify the genetic variations between the qacA/B positive isolates. The results showed that all isolates contained mecA gene. The seond common gene found in the isolates was the blaZ gene, followed by norA, qacA/B and smr. As for genes qacG and qacH, they were not detected. In addition, the antibiotic sensitivity profile was varied among all isolates. However, these isolates were sensitive to only three antibiotics; linezolid, teicoplanin and vancomycin. Furthermore, the MBC for chlorhexidine was ranged from 0.94-60 mg/l. The MRSA, which had a reduced sensitivity to chlorhexidine and that contained qacA/B, all had results that showed similar PFGE patterns (>80%), and based on the MLST results, they all shared the sequence type 239.
Appears in Programs:0712 Medical Laboratory Sciences

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