RESUMO
Objectives: The objectives of this study were to determine the frequency of methicillin-resistant Staphylococcus aureus [MRSA] colonization or infection while on admission to the intensive care unit [ICU], and examine the genetic backgrounds of the MRSA isolates to establish transmission among the patients
Subjects and Methods: This study involved screening 2,429 patients admitted to the ICU of Farwania Hospital from January 2005 to October 2007 for MRSA colonization or infection. The MRSA isolates acquired after admission were investigated using a combination of molecular typing techniques to determine their genetic backgrounds
Results: Of 2,429 patients screened, 25 [1.0%] acquired MRSA after admission to the ICU. Of the 25 MRSA, 19 [76%] isolates belonged to health care-associated [HA-MRSA] clones: ST239-III [n = 17, 68%] and ST22-IV [n = 2, 8%]. The remaining 6 MRSA isolates belonged to community-associated clones: ST80-IV [n = 3, 12%], ST97-IV [n = 2, 8%], and ST5-IV [n = 1, 4%]. The ST239-III-MRSA clone was associated with infection as well as colonization, and was isolated from patients from 2005 to 2007
Conclusions: The HA-MRSA clone ST239-III persistently colonized patients admitted to the ICU, indicating the possibility of its transmission among the patients over time
RESUMO
Objective: The aim of this study was to determine antibiotic resistance trends and carriage of staphylococcal cassette chromosome mec [SCC mec ] genetic elements in methicillinresistant Staphylococcus aureus [MRSA] isolated in Kuwait hospitals to ascertain whether they were healthcare associated [HA-MRSA] or community associated [CA-MRSA]
Materials and Methods: In total, 6,922 MRSA isolates obtained from different clinical samples were tested for resistance to antibiotics, urease production, and carriage of SCC mec elements
Results: All MRSA isolates were susceptible to linezolid, vancomycin, and teicoplanin. However, some isolates were resistant to kanamycin [2,979; 43%], ciprofloxacin [2,955; 42.7%], erythromycin and clindamycin [2,935; 42.4%], fusidic acid [2,858; 41.2%], gentamicin [2,665; 38.5%], tetracycline [2,652; 38.3%], and trimethoprim [2,324; 33.5%]. Whereas the prevalence of resistance to most antibiotics showed annual variations, those resistant to chloramphenicol and rifampicin increased from 2.6 and 0.1% to 9.6 and 1.6%, respectively, and high-level mupirocin resistance declined from 9.3% in 2011 to 3.6% in 2015. In total, 3,244 [53.9%] of the isolates carried SCC mec IV followed by SCCmec III [1,737; 28.8%] and SCC me c V [890; 14.8%]. SCC mec I [21; 0.3%] and II [79; 0.8%] occurred sporadically. A total of 3,651 [60.7%] of the isolates belonged to the CA-MRSA genotype and 2,290 isolates [38.1%] were identified as HAMRSA
Conclusion: This study demonstrates changes in antibiotic resistance patterns of MRSA over time and reinforces the value of surveillance in detecting such changes for the benefit of infection control and patient management