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Change in meticillin-resistant Staphylococcus aureus clones at a tertiary care hospital in the United Arab Emirates over a 5-year period
  1. Ágnes Sonnevend1,
  2. Iain Blair2,
  3. Mohammed Alkaabi3,
  4. Pauline Jumaa4,
  5. Mohammed al Haj1,
  6. Akela Ghazawi1,
  7. Nadia Akawi5,
  8. Fatima Saeed Jouhar1,
  9. Mohammad Baraa Hamadeh3,
  10. Tibor Pál1
  1. 1Department of Microbiology and Immunology, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
  2. 2Department of Community Medicine, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
  3. 3Tawam Hospital, Al Ain, United Arab Emirates
  4. 4Department of Clinical Microbiology and Infection Control, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  5. 5Department of Pathology, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
  1. Correspondence to Professor Tibor Pál, Department of Microbiology and Immunology, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain POB 17666, United Arab Emirates; tpal{at}uaeu.ac.ae

Abstract

Aims Meticillin-resistant Staphylococcus aureus (MRSA) strains isolated in Tawam Hospital, a tertiary care hospital in the United Arab Emirates, were examined in order to understand the reasons for a doubling of its incidence between 2003 and 2008 while maintaining the same infection control measures.

Methods All consecutive non-duplicate clinically relevant MRSA isolates recovered between January and December 2003 and between May and October 2008 were studied. The antibiotic susceptibility, pulsed field gel electrophoresis, toxin gene, staphylococcal cassette chromosome mec (SCCmec), spa, agr and multilocus sequence types of the strains were tested.

Results In 2003, typical healthcare-associated (HA-MRSA) genotypes (ST239-MRSA-III, ST22-MRSA-IV and ST5-MRSA-II) represented the majority (61.5%) of the isolates. By 2008 this pattern had changed and clonal types considered as community-associated (CA) MRSA comprised 73.1% of the strains with ST80-MRSA-IV, ST5-MRSA-IV and ST1-MRSA with non-typable SCCmec types being the most frequent. However, further epidemiological investigations showed that only one-third of the CA-MRSA infections were actually acquired in the community, indicating that CA-MRSA clones have entered and spread within the hospital.

Conclusions The emergence of CA-MRSA clones with subsequent entry to and spread within the hospital has contributed to the increasing incidence of MRSA observed in Tawam Hospital and probably also in other hospitals in the UAE.

  • MRSA
  • epidemiology
  • hospital infections
  • antibiotics
  • microbiology
  • microbial pathogenic
  • microbial genetics
  • hospital hygiene
  • blood culture
  • bacteraemia
  • yeast
  • clinical infectious diseases
  • fungi
  • bacteriology
  • automation
  • infection control
  • enteric infections
  • salmonella
  • stool culture media

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Footnotes

  • Funding This work was supported by UAEU Faculty of Medicine and Health Sciences grants to AS (NP/08/08 and NP/09/15) and to TP (NP/04/08).

  • Competing interests None.

  • Ethics approval Ethics approval was provided by Al Ain District human research ethics committee (Protocol No. 07/154).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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