Emergence of Methicillin-Resistant Staphylococcus aureus Belonging to Clonal Complex 15 (CC15-MRSA) in Kuwait Hospitals

Figures & data

Figure 1 PFGE patterns of representative CC15-MRSA-V+SCCfus isolates. Lane 1, PFGE type D. Lane 2, S. aureus strain NCTC8325. Lane 3, PFGE type A1. Lane 4, PFGE type A2. Lane 5, PFGE type A. Lane 6, PFGE type B. Lane M, PFGE type C.

Figure 2 Plasmid content of representative CC15-MRSA-V+SCCfus isolates. Lanes 1, 2, and 4 contain single plasmid of c.28-kb. Lane 3, contains 2 plasmids of c.28-kb and 4.4-kb. Lane M, contains plasmid size markers. Sizes are in Kb.

Table 1 Characteristics of CC15-MRSA-V+SCCfus Isolates

Relevant Genes	Spa Types
	t084, N=31	t084, N=1	t084, N=1	t084, N=1	t084, N=1	t084, N=1	t228, N=1	t114, N=1	t346, N=1	t7583, N=1
Regulatory Genes
SarA	+	+	+	+	+	+	+	+	+	+
Saes	+	+	+	+	+	+	+	+	+	+
Agr II	+	+	+	+	+	+	+	+	+	+
Resistance Genotype
mecA	+	+	+	+	+	+	+	+	+	+
BlaZ	+	+	+	+	+	+	+	+	+	+
BlaI	+	+	+	+	+	+	+	+	+	+
aacA-aphD	+	+	+	+	+	+	+	+	+	+
aphA3	−	−	−	−	−	−	−	−	−	−
aadD	+	−	+	+	+	−	+	+	+	+
fusC	+	+	+	+	+	+	+	+	+	+
Inu(A)	+	+	+	+	+	+	+	+	+	+
erm(C))	−	−	−	−	+	−	−	−	−	−
Tet(K)	+	−	+	+	−	−	+	+	+	+
fosB	+	+	+	+	+	+	+	+	+	+
Toxins
tst1	−	−	−	−	−	−	−	−	−	−
Enterotoxins	−	−	−	−	−	−	−	−	−	−
Leukocidins
lukF	+	+	+	+	+	+	+	+	+	+
lukS	+	+	+	+	+	+	+	+	+	+
hlgA	+	+	+	+	−	+	+	+	+	+
lukD	+	+	+	+	+	+	+	+	+	+
lukE	+	+	+	+	−	+	+	+	+	+
lukX	+	+	+	+	−	+	+	+	+	+
lukY	+	+	+	+	+	+	+	+	+	+
Haemolysins
hl	+	+	+	+	+	+	+	+	+	+
hla	+	+	+	+	−	+	+	+	+	+
hlb	+	+	−	+	−	+	+	+	−	+
hllll	+	+	+	+	+	+	+	+	+	+
Immune Evasion Clusters (IEC)
Sak	−	−	−	−	−	−	−	−	−	−
Chp	+	+	+	+	+	+	+	+	+	+
Scn	+	+	+	+	−	+	+	+	+	+
Proteases
splA	+	+	+	+	+	+	+	+	+	+
splB	+	+	+	+	+	+	+	+	+	+
splE	+	+	+	+	−	+	+	+	+	+
Proteases
sspA	+	+	+	+	+	+	+	+	+	+
sspB	+	+	+	+	+	+	+	+	+	+
Restriction Modification System
hsdS1	−	−	−	−	−	−	−	−	−	−
hsdS2	−	−	−	−	−	−	−	−	−	−
hsdS3	−	−	−	−	−	−	−	−	−	−
hsdSx (CC15)	+	+	+	+	+	+	+	+	+	+
hsdSx (etd)	−	−	−	−	−	−	−	−	−	−

Notes: +, gene present; −, gene not detected.

Abbreviations: lukF, leukocidin component B (F); lukS, leukocidin component C (S); hlgA, haemolysins gamma, component A; lukD, leukocidin D component; lukE, leukocidin E component; luKX, leukocidin/haemolysin toxin family protein (luKB or lukG); luKY, leukocidin/haemolysins toxin family protein (luKA or luKH); hl, putative membrane protein; hla, haemolysins alpha; hlb, haemolysins beta; hllll, putative membrane protein; sak, staphylokinase; chp, chemotaxis-inhibiting protein; scn, staphylococcal component inhibitor; splA, serine protease A; splB, serine protease B; splE, serine protease E; sspA, glutamylendopeptidase; sspB, staphopain B, protease.

Table 2 Isolation and Distribution of CC15-MRSA-V+SCCfus Isolates

Months	Hospitals
	MUB	ADH	JH	RAZ	MAT	SAB	CDH	FAW	Total
January					1				1
February	1				1				2
March	2	1							3
April			1		1				2
May	3		1		1				5
June	1				2				3
July				1	1				2
August	3	1		1	1			1	7
September			1			1			2
October					1	1			2
November	3	1				1	1	2	8
December		1		1	2	1			5
Total	13	4	3	3	11	4	1	3	42

Abbreviations: MUB, Mubarak hospital; ADH, Adan hospital; JH, Jahra hospital; RAZ, Razi hospital; MAT, Maternity hospital; SAB, Sabah hospital; CDH, Chest-Disease hospital; FAW, Farwaniya hospital.

Table 3 Distribution of t084 in Clinical Samples in Different Hospitals

Hospitals	Blood	Groin	Nasal	Wound	HVS**	Skin	Others*	Total
MUB	2	1	4	–	–	–	3	10
ADH			1	2		1		4
JH		1	1		1			3
RAZ			1			2		3
MAT			1	4	3		1	9
SAB		1				1	2	4
CDH			1					1
FAW				2				2
Total	2	3	9	8	4	4	6	36

Notes: *Include sputum, tracheal aspirate, Urine, unspecified. **high vaginal swab.