AUTHOR=Boswihi Samar S. , Verghese Tina , Udo Edet E. 

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

JOURNAL=Frontiers in Microbiology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2022.970924

DOI=10.3389/fmicb.2022.970924

ISSN=1664-302X

ABSTRACT=<p>CC22-MRSA is a major MRSA lineage that is widely reported globally. To characterize CC22-MRSA for trends in antibiotic resistance and emergence of variants, a total of 636 CC22 isolates identified by DNA microarray in 2016 (<italic>n</italic> = 195), 2017 (<italic>n</italic> = 227) and 2018 (<italic>n</italic> = 214) were investigated further using staphylococcal protein A (<italic>spa</italic>) typing and multilocus sequence typing. The isolates belonged to 109 <italic>spa</italic> types dominated by t223 (<italic>n</italic> = 160), t032 (<italic>n</italic> = 60), t852 (<italic>n</italic> = 59), t005 (<italic>n</italic> = 56) and t309 (<italic>n</italic> = 30) and 10 sequence types (STs) dominated by ST22 (85.5%). Genotypes CC22-MRSA-IV [tst1<sup>+</sup>]; CC22-MRSA-IV UK-EMRSA-15/Barnim EMRSA variants, CC22-MRSA-IV [PVL<sup>+</sup>], CC22-MRSA-IV [tst1<sup>+</sup>/PVL<sup>+</sup>] and CC22-MRSA-IV + V constituted &gt;50% of the isolates. An increase from 2016 to 2018 were shown in isolates belonging to <italic>spa</italic> types t223 (43 to 62), t032 (18 to 27) and t309 (10 to 15) and genotypes CC22-MRSA-IV [tst1<sup>+</sup>] (89 to 102), CC22-MRSA-IV + V (12 to 30) and CC22-MRSA-IV [tst1<sup>+</sup>/PVL<sup>+</sup>] (12 to 22). Ninety-nine CC22-MRSA isolates were multi-resistant to three or more antibiotic classes with 76.7% of them belonging to CC22-MRSA-IV [PVL<sup>+</sup>] and CC22-MRSA-IV [tst1<sup>+</sup>/PVL<sup>+</sup>]. The study revealed an ongoing domination of the CC22-MRSA-[tst1<sup>+</sup>] genotype and the emergence of new clones bearing SCC<italic>mec</italic> IV + V and multiply resistant variants.</p>