Antibiotic Resistance Trends in Methicillin-resistant Staphylococcus aureus isolated in Kuwait hospitals: 2011-2015

Objective:
The aim of this study was to determine antibiotic resistance trends and carriage of staphylococcal cassette chromosome mec (SCCmec) genetic elements in methicillin-resistant Staphylococcus aureus (MRSA) isolated in Kuwait hospitals to ascertain whether they were healthcare-associated (HA-MRSA) or community-associated (CA-MRSA).
Materials (Subjects) and Methods
In total 6,922 MRSA isolates obtained from different clinical samples were tested for resistance to antibiotics, urease production and carriage of SCCmec elements.
Results:
All MRSA isolates were susceptible to linezolid, vancomycin and teicoplanin. However, some isolates were resistant to kanamycin (2979 ; 43%), ciprofloxacin (2955; 42.7%), erythromycin and clindamycin (2935; 42.4%), fusidic acid (2858; 41.2%), gentamicin (2665; 38.5%), tetracycline (2652; 38.3%) and trimethoprim (2324; 33.5%). Whereas the prevalence of resistance to most antibiotics showed annual variations, those of resistance to chloramphenicol and rifampicin increased from 2.6% and 0.1% to 9.6% and 1.6% respectively, and high-level mupirocin declined from 9.3% in 2011 to 3.6% in 2015. In total, 3244 (53.9%) of the isolates carried SCCmec IV followed by SCCmec III (1737 (28.8%) and SCCmec V: (890; 14.8%). SCCmec I (21; 0.3%) and II (79; 0.8%) occurred sporadically. A total of 3651 (60.7%) of the isolates belonged to CA-MRSA genotype and 2290 (38.1%) isolates were identified as HA-MRSA.
Conclusion:
The study demonstrated changes in antibiotic resistance patterns of MRSA overtime and reinforces the value of surveillance in detecting such changes for the benefit of infection control and patient management.



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