scholarly journals The Prevalence of Inducible Clindamycin Resistance Staphylococcus aureus among Various Clinical Specimens in Khartoum state Sudan

2021 ◽  
pp. 13-21
Author(s):  
Safana A. A. Alhady ◽  
Musa Abdalla Ali
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Agents ◽  
University Hospital ◽  
P Value ◽  
Cross Sectional ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance ◽  
Antimicrobial Susceptibility Profile ◽  
Significant Difference ◽  
Mrsa Strains

Background : S. aureus is frequently associated with skin infections, pneumonia, surgery wounds, bacteraemia, osteomyelitis and endocarditis, being considered one of the most important pathogens of the human being, both at the community level and at nosocomial infections, and may become serious if caused by antimicrobial resistant strains, especially methicillin-resistant S. aureus (MRSA) strains, which are resistant to most of the antimicrobial agents, methicillin-sensitive S.aureus (MSSA) and isolates with reduced susceptibility and resistance to vancomycin, which is the last drug for the treatment of MRSA infections. So, this study aimed to detect the existence of inducible resistance of S. aureus to Clindamycin in Khartoum-Sudan among patients attended to Suba University Hospital. Methods : The study was performed as cross-sectional one, 53 clinical isolates of S. aureus obtained from (34 females and 19 males) with different clinical condition among patients attended to Suba University Hospital in Khartoum-Sudan from April to August 2017. To detect inducible clindamycin resistant by using D test. In addition to that MRSA / MSSA all the isolates screened for methicillin resistant by using 1 µg oxacillin then examined for inducible clindamycin resistant by D test. In addition to that examine for antimicrobial susceptibility profile which include vancomycin, gentamycin, tetracycline and co-trimoxazole. The data were analyzed using Statistical Package for Social Science, version 22, P. value <0.05 was considered statistically significant Results : out of 53 isolates, 36 S. aureus isolated resistant to Clindamycin, 26 (72.2%) were MRSA and 10 (27.8%) were MSSA by means of D test, while 17 (32.1%) of isolates were sensitive 9 (53%) MRSA and 8 (47 %) MSSA. Comparing Induced clindamycin resistance showed equally distribution among MSSA and MRSA isolates, giving no significant difference as P- value 0.167. Conclusion : This study showed that D.test to detect inducible clundamycin resistance in staphylococcus aureus.

scholarly journals Methicillin-Resistant Staphylococcus aureus Recovered from Healthcare- and Community-Associated Infections in Egypt

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Mohamed Abdel-Maksoud ◽  
Mona El-Shokry ◽  
Ghada Ismail ◽  
Soad Hafez ◽  
Amani El-Kholy ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Continuous Monitoring ◽  
Inhibitory Concentration ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance ◽  
The Past ◽  
Mrsa Strains ◽  
Healthcare Associated ◽  
Over Time

Background. Methicillin-resistant Staphylococcus aureus (MRSA) has created significant epidemiological, infection-control, and therapeutic management challenges during the past three decades. Aim. To analyze the pattern of resistance of healthcare- and community-associated MRSA in Egypt and the trend of resistance of HA-MRSA over time (2005–2013). Methods. MRSA isolates were recovered from healthcare-associated (HA) and community-associated (CA) Staphylococcus aureus (S. aureus) infections. They were tested against 11 antimicrobial discs and the minimal inhibitory concentration (MIC) of vancomycin was determined. Inducible clindamycin resistance (iMLSB) was also screened using D-test. Findings. Of 631 S. aureus, MRSA was identified in 343 (76.6%) and 21 (11.5%) of HA and CA S. aureus isolates, respectively. The proportion of HA-MRSA increased significantly from 48.6% in 2005 to 86.8% in 2013 (p value < 0.001). Multidrug resistance (MDR) was observed in 85.8% of HA-MRSA and 48.6% of CA-MRSA. Vancomycin intermediate resistant S. aureus (VISA) was detected in 1.2% of HA-MRSA and none was detected in CA-MRSA. Among HA-MRSA strains, 5.3% showed iMLSB compared to 9.5% among CA-MRSA. Conclusion. The upsurge of the prevalence rates of HA-MRSA over time is alarming and urges for an effective infection control strategy and continuous monitoring of antimicrobial use.

scholarly journals 554. The Changing Epidemiology of Methicillin-Resistant Staphylococcus aureus Causing Bacteremia in Hiroshima, Japan During 2008–2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S263-S263
Author(s):  
Hiroki Kitagawa ◽  
Junzo Hisatsune ◽  
Hiroki Ohge ◽  
Motoyuki Sugai
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Sccmec Type ◽  
University Hospital ◽  
Methicillin Resistant ◽  
Type Iv ◽  
Time Period ◽  
Invasive Infections ◽  
Toxic Shock Syndrome Toxin ◽  
Mrsa Strains

Abstract Background Recently, the Japanese intrinsic community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) clone (CA-MRSA/J), classified as sequence type (ST) 8 carrying staphylococcal cassette chromosome mec (SCCmec) type IVl (ST8-IVl), has been identified that causes invasive infections similar to those of USA300 clone. However, epidemiological information regarding epidemic CA-MRSA clones is limited in Japan. This study was performed to investigate the changing epidemiology of MRSA causing bacteremia in Japan. Methods We performed whole-genome sequencing of MRSA isolates causing bacteremia at Hiroshima University Hospital between January 2008 and December 2017. MRSA isolates were subjected to multilocus sequence typing, SCCmec typing and were analyzed for virulence factors. Clinical data of patients with MRSA bacteremia were analyzed. Results A total of 193 MRSA strains causing bacteremia were identified during the study period. Among these, most belonged to ST764-IIa (30%; 59 of 193) and ST5-IIa (26.9%; 52 of 193). The proportion of ST5-IIa MRSA decreased from 39.6% (42 of 106) in 2008–2012 to 11.5% (10 of 87) in 2013–2017, and that of ST764-IIa MRSA increased from 23.6% (25 of 106) to 39.1% (34 of 87) in the same time period. The proportion of CA-MRSA (MRSA carrying SCCmec type IV or V) increased from 28.3% (30 of 106) in 2008–2012 to 42.5% (37 of 87) in 2013–2017. In CA-MRSA strains, clonal complex (CC) 8-IV MRSA was predominant (76.1%; 51 of 67). Those belonging to CC8-IV MRSA isolates were ST380-IVc (18 of 51), ST8-IVl (CA-MRSA/J; 15 of 51), ST8-IVj (15 of 51), ST8-IVa (2 of 51), and ST4803-IVl (1 of 51). The rate of hospital-onset infections of ST380-IVc, ST8-IVl, and ST8-IVj were 83.3%, 46.7%, and 60%, respectively. In CA-MRSA/J strains, including their variants (e.g., ST4803-IVl), 14 of 16 strains (87.5%) carried genes for toxic shock syndrome toxin (tst-1), enterotoxin C (sec), and enterotoxin L (sel), while none of the ST380-IVc and ST8-IVj MRSA strains carried these genes. Conclusion During the study period of 10 years, predominant ST5-IIa MRSA causing hospital-onset infections was replaced by ST764-IIa MRSA. In CA-MRSA clone, ST380-IVc, ST8-IVl (CA-MRSA/J), and ST8-IVj were dominant and have already spread to the healthcare environment. Disclosures All authors: No reported disclosures.

scholarly journals Missense Mutations in PBP2A Affecting Ceftaroline Susceptibility Detected in Epidemic Hospital-Acquired Methicillin-Resistant Staphylococcus aureus Clonotypes ST228 and ST247 in Western Switzerland Archived since 1998

2015 ◽  
Vol 59 (4) ◽  
pp. 1922-1930 ◽  
Author(s):  
William L. Kelley ◽  
Ambre Jousselin ◽  
Christine Barras ◽  
Emmanuelle Lelong ◽  
Adriana Renzoni
Keyword(s):  
Staphylococcus Aureus ◽  
University Hospital ◽  
Surveillance Program ◽  
Missense Mutations ◽  
Unknown Parameters ◽  
Methicillin Resistant ◽  
Content Type ◽  
Resistant Strains ◽  
Mrsa Strains

ABSTRACTThe development and maintenance of an arsenal of antibiotics is a major health care challenge. Ceftaroline is a new cephalosporin with activity against methicillin-resistantStaphylococcus aureus(MRSA); however, no reports concerning MRSA ceftaroline susceptibility have been reported in Switzerland. We tested thein vitroactivity of ceftaroline against an archived set of 60 MRSA strains from the University Hospital of Geneva collected from 1994 to 2003. Our results surprisingly revealed ceftaroline-resistant strains (MIC, >1 μg/ml in 40/60 strains; EUCAST breakpoints, susceptible [S], ≤1 μg/ml; resistant [R], >1 μg/ml) were present from 1998 to 2003. The detected resistant strains predominantly belonged to sequence type 228 (ST228) (South German clonotype) but also to ST247 (Iberian clonotype). A sequence analysis of these strains revealed missense mutations in the penicillin-binding protein 2A (PBP2A) allosteric domain (N146K or E239K and N146K-E150K-G246E). The majority of our ST228 PBP2A mutations (N146K or E150K) were distinct from ST228 PBP2A allosteric domain mutations (primarily E239K) recently described for MRSA strains collected in Thailand and Spain during the 2010 Assessing Worldwide Antimicrobial Resistance Evaluation (AWARE) global surveillance program. We also found that similar allosteric domain PBP2A mutations (N146K) correlated with ceftaroline resistance in an independent external ST228 MRSA set obtained from the nearby University Hospital of Lausanne, Lausanne, Switzerland, collected from 2003 to 2008. Thus, ceftaroline resistance was observed in our archived strains (including two examples of an MIC of 4 µg/ml for the Iberian ST247 clonotype with the triple mutation N146K/E150K/G246E), at least as far back as 1998, considerably predating the commercial introduction of ceftaroline. Our results reinforce the notion that unknown parameters can potentially exert selective pressure on PBP2A that can subsequently modulate ceftaroline resistance.

scholarly journals Peculiarities of antibiotic resistance of Staphylococcus aureus strains isolated from nosocomial infections

2020 ◽  
Vol 101 (3) ◽  
pp. 325-329
Author(s):  
S A Atakishizade
Keyword(s):  
Antibiotic Resistance ◽  
Nosocomial Infections ◽  
Methicillin Resistance ◽  
Surgical Site Infections ◽  
Diffusion Method ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance ◽  
Significant Difference ◽  
Microbiological Testing ◽  
Mrsa Strains

Aim. To study of the antibiotic resistance of S. aureus strains isolated from nosocomial infections (pneumonia, surgical site infections and sepsis) in a multidisciplinary surgical clinic. Methods. Microbiological testing of sputum in 41 patients with pneumonia, of samples (wound, abscess, drainage) obtained from 40 patients with surgical site infections (SSI) and of blood from 46 patients with signs of sepsis was performed. The obtaining cultures were identified by conventional methods (including morphological, cultural, biochemical features, etc.). Disc diffusion method was used to detect methicillin-resistant S. aureus (MRSA) strains. Inducible clindamycin resistance (ICR) of S. aureus strains was determined by double disk approximation test (D-test). Results. Methicillin-resistant S. aureus was found in 14.3% (2 of 14) of the patients with surgical site infections, in the sputum 27.3% (3 of 11) of the patients with pneumonia, and in the blood 50.0% (7 of 14) of the patients with sepsis (p 0.05). The rate of inducible clindamycin resistance of isolated S. aureus strains in patients with surgical site infections (2 of 14 cases, 14.3%) and with pneumonia (2 of 11 cases, 18.2%) did not statistically significant difference with the rate of methicillin resistance (p 0.05). However the rate was significantly lower septic infections 7.1% and 50.0% respectively (p=0.0328). Conclusion. Among S. aureus strains isolated from nosocomial infections, the rate of methicillin-resistant S. aureus had not depended on the type of nosocomial infection; the rate of inducible clindamycin resistance in septic infections was lower than resistance to methicillin.

scholarly journals PREVALENCE OF NASAL CARRIAGE OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS AMONG HEALTHCARE WORKERS IN THE DEPARTMENTS OF OTORINOLARYNGOLOGY AND DENTISTRY IN KYIV, UKRAINE

2020 ◽  
Vol 73 (12) ◽  
pp. 2563-2567
Author(s):  
Aidyn G. Salmanov ◽  
Taras P. Bondar ◽  
Yaroslav V. Shkorbotun ◽  
Evelina A. Chumak ◽  
Volodymyr O. Shkorbotun ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Virulence Factor ◽  
Healthcare Workers ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Nasal Carriage ◽  
Diffusion Method ◽  
Methicillin Resistant ◽  
Significant Difference ◽  
Mrsa Strains ◽  
Encoding Genes

The aim: To obtain the first estimates of the current prevalence of nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) among healthcare workers (HCWs) in the departments of Otorinolaryngology and Dentistry and to determine of genes virulence factors (Panton Valentine Leukocidine (PVL) genes). Materials and methods: We performed a multicenter cross-sectional study. The susceptibility to antibiotics was determined by disk diffusion method according to the European Committee on Antimicrobial Susceptibility Testing. The virulence factor encoding genes, mecA, lukS-lukF, were detected by Polymerase Chain Reaction (PCR). Results: Incidence rate of S. aureus nasal carriage among HCWs was 36.2%, whereas MRSA carriage was 17%. Prevalence of MRSA carriage rate was 34.9% in Otorhinolaryngology departments and 9.7% in Dentistry. PCR testing confirmed that all MRSA strains were mecA gene-positive. The virulence factor encoding genes were detected in 82.3% of the S. aureus isolates from HCWs. Among S.aureus, the lukS-lukF genes were detected in over 59% of the strains. The lukS-lukF genes were detected in 55.5% of MRSA and in 58.9% of MSSA strains. LukS-lukF genes were most commonly co-present in MRSA strains. No significant difference was detected between the occurrences of lukS-lukF genes (P > 0.05). Conclusions: Personnell in otorhinolaryngology and dentistry departments have a high rate of nasal colonization of MRSA. This carrier state may be an important risk factor for transmission MRSA from physicians and nurses to patients and vice-versa. Screening for MRSA nasal carriage of HCWs is a key element in enabling infection control measures and early therapeutic decisions.

scholarly journals Ability of biofilm production and molecular analysis of spa and ica genes among clinical isolates of methicillin-resistant Staphylococcus aureus

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Mitra Omidi ◽  
Farzaneh Firoozeh ◽  
Mahmood Saffari ◽  
Hossein Sedaghat ◽  
Mohammad Zibaei ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cross Sectional Study ◽  
Clinical Isolates ◽  
Cross Sectional ◽  
Disk Diffusion Test ◽  
Methicillin Resistant ◽  
Isfahan Province ◽  
Biofilm Production ◽  
Mrsa Strains

Abstract Objective This study aimed to evaluate the phenotypic and genotypic characterization of biofilm formation and spa and ica genes among clinical isolates of methicillin-resistant Staphylococcus aureus. Result This cross-sectional study was performed on 146 Staphylococcus aureus isolates from hospitalized patients in Isfahan Province Hospitals. MRSA isolates were confirmed using disk diffusion test with oxacillin disk and amplification of mecA gene by PCR assays. Ability of biofilm production was evaluated targeting the icaA and icaD genes. Of 146 Staphylococcus aureus isolates, 24 (16.4%) carried mecA genes and identified as MRSA strains. Strong ability of biofilm production was seen among 76.02% (111/146) S. aureus isolates and 87.5% (21/24) MRSA strains, respectively. Also, 75.0% (18/24) MRSA isolates carried icaA and icaD was not detected in these strains. Analysis of spa gene showed 70.83% (17/24) MRSA strains were spa positive. From which 14 and 3 strains identified with one band (150, 270, 300, 360, 400 bp) and two bands (150–300 bp), respectively. According to data obtained, the prevalence of MRSA isolates from Isfahan Province Hospitals is relatively high and a remarkable percentage of them show strong power in biofilm production. Also analysis of spa gene showed a fairly large diversity among MRSA strains.

scholarly journals Livestock-Associated Methicillin-Resistant Staphylococcus aureus (MRSA) in Purulent Subcutaneous Lesions of Farm Rabbits

Foods ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. 439 ◽  
Author(s):  
Vanessa Silva ◽  
Telma de Sousa ◽  
Paula Gómez ◽  
Carolina Sabença ◽  
Madalena Vieira-Pinto ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Agents ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Spa Typing ◽  
Disk Diffusion Method ◽  
Methicillin Resistant ◽  
Resistance To Penicillin ◽  
Mrsa Strains

Methicillin-resistant Staphylococcus aureus (MRSA) are one of the main pathogens associated with purulent infections. MRSA clonal complex 97 (CC97) has been identified in a wide diversity of livestock animals. Therefore, we aimed to investigate the antibiotic resistance profiles of MRSA strains isolated from purulent lesions of food-producing rabbits. Samples from purulent lesions of 66 rabbits were collected in a slaughterhouse in Portugal. Samples were seeded onto ORSAB plates with 2 mg/L of oxacillin for MRSA isolation. Susceptibility to antibiotics was tested by the disk diffusion method against 14 antimicrobial agents. The presence of resistance genes, virulence factors and the immune evasion cluster (IEC) system was studied by polymerase chain reaction. All isolates were characterized by multilocus sequence typing (MLST), agr and spa typing. From the 66 samples analyzed, 16 (24.2%) MRSA were detected. All strains were classified as multidrug-resistant as they were resistant to at least three classes of antibiotics. All isolates showed resistance to penicillin, erythromycin and clindamycin. Seven isolates were resistant to gentamicin and harbored the aac(6′)-Ie-aph (2″)-Ia gene. Resistance to tetracycline was detected in 10 isolates harboring the tet(K) gene. The IEC genes were detected in three isolates. MRSA strains belonged to CC97, CC1, CC5, CC15 or CC22. The isolates were assigned to six different spa types. In this study we found a moderate prevalence of multidrug-resistant MRSA strains in food-producing rabbits. This may represent concern for food safety and public health, since cross-contamination may occur, leading to the spread of MRSA and, eventually, the possibility of ingestion of contaminated meat.

scholarly journals Phenotypic study of Macrolide-Lincosamide-Streptogramin B Resistance in Staphylococcus aureus and their relationship with Methicillin-Resistant Staphylococcus aureus (MRSA) at Tertiary Care in Eastern Nepal

2016 ◽  
Vol 5 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Ganesh Kumar Singh ◽  
Bigu Kumar Chaudhari ◽  
Kamal Prasad Parajuli
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Agents ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance ◽  
Constitutive Resistance ◽  
Antibiotic Susceptibility Test

Background Resistance to antimicrobial agents is prevalent among Staphylococci. This has led to wide uses of macrolide-lincosamide-streptogramin B (MLSB) antibiotics to Staphylococcus aureus (S. aureus) infections. MLSB though chemically distinct, have similar target site and mode of action. The multiple mechanisms are responsible for resistance to MLSB antibiotics which can lead to clinical failure. The aim of the study was to investigate the frequency of inducible and constitutive clindamycin resistance among clinical isolates of S. aureus and their relationship with Methicillin-resistant Staphylococcus aureus (MRSA).Material & Methods A total of 336 unique Staphylococcus aureus isolates from different clinical samples obtained from patients were studied. Antibiotic susceptibility test was performed by Kirby- Bauer disc diffusion method. “D test” was performed to detect inducible clindamycin resistance as per CLSI guidelines. MRSA was detected using Cefoxitin (30μg) and results were interpreted according to CLSI criteria.Results Inducible clindamycin resistance was seen in 45 (13.39%), constitutive clindamycin resistance was seen among 58 (17.26%) while MS phenotype was observed among 38(11.30%) of isolates. Inducible resistance as well as constitutive resistance was higher among MRSA as compared to MSSA (21.11%, 4.48% and 21.11%, 12.82%respectively).Conclusion The Successful use of clindamycin for the treatment of infection caused by S. aureus can be predicted based on the result of simple and inexpensive D test.Journal of Nobel Medical CollegeVolume 5, Number 1, Issue 8, January-July 2016, 1-5

scholarly journals Increasing Prevalence of Methicillin-Resistant Staphylococcus aureus Causing Nosocomial Infections at a University Hospital in Taiwan from 1986 to 2001

2004 ◽  
Vol 48 (4) ◽  
pp. 1361-1364 ◽  
Author(s):  
Po-Ren Hsueh ◽  
Lee-Jene Teng ◽  
Wen-Hwei Chen ◽  
Huei-Ju Pan ◽  
Mei-Lin Chen ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Nosocomial Infections ◽  
Antimicrobial Agents ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
University Hospital ◽  
Methicillin Resistant ◽  
Mrsa Infection ◽  
Rapid Emergence

ABSTRACT A rapid emergence of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection (from 26.3% in 1986 to 77% in 2001) was found. The susceptibility of 200 nonduplicate blood isolates of MRSA and 100 MRSA isolates causing refractory bacteremia to 22 antimicrobial agents disclosed that glycopeptides, quinupristin-dalfopristin, and linezolid remained the most active agents.

scholarly journals Extensive Genetic Diversity Identified among Sporadic Methicillin-Resistant Staphylococcus aureus Isolates Recovered in Irish Hospitals between 2000 and 2012

2014 ◽  
Vol 58 (4) ◽  
pp. 1907-1917 ◽  
Author(s):  
Peter M. Kinnevey ◽  
Anna C. Shore ◽  
Grainne I. Brennan ◽  
Derek J. Sullivan ◽  
Ralf Ehricht ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Agents ◽  
Sequence Type ◽  
Methicillin Resistant ◽  
Content Type ◽  
Type Assignment ◽  
Antimicrobial Resistance Genes ◽  
Microarray Profiling ◽  
Mrsa Strains ◽  
Ongoing Surveillance

ABSTRACTClonal replacement of predominant nosocomial methicillin-resistantStaphylococcus aureus(MRSA) strains has occurred several times in Ireland during the last 4 decades. However, little is known about sporadically occurring MRSA in Irish hospitals or in other countries. Eighty-eight representativepvl-negative sporadic MRSA isolates recovered in Irish hospitals between 2000 and 2012 were investigated. These yielded unusual pulsed-field gel electrophoresis and antibiogram-resistogram typing patterns distinct from those of the predominant nosocomial MRSA clone, ST22-MRSA-IV, during the study period. Isolates were characterized byspatyping and DNA microarray profiling for multilocus sequence type (MLST) clonal complex (CC) and/or sequence type (ST) and SCCmectype assignment, as well as for detection of virulence and antimicrobial resistance genes. Conventional PCR-based SCCmecsubtyping was undertaken when necessary. Extensive diversity was detected, including 38spatypes, 13 MLST-CCs (including 18 STs among 62 isolates assigned to STs), and 25 SCCmectypes (including 2 possible novel SCCmecelements and 7 possible novel SCCmecsubtypes). Fifty-four MLST-spa-SCCmectype combinations were identified. Overall, 68.5% of isolates were assigned to nosocomial lineages, with ST8-t190-MRSA-IID/IIE ± SCCM1predominating (17.4%), followed by CC779/ST779-t878-MRSA-ψSCCmec-SCC-SCCCRISPR(7.6%) and CC22/ST22-t032-MRSA-IVh (5.4%). Community-associated clones, including CC1-t127/t386/t2279-MRSA-IV, CC59-t216-MRSA-V, CC8-t008-MRSA-IVa, and CC5-t002/t242-MRSA-IV/V, and putative animal-associated clones, including CC130-t12399-MRSA-XI, ST8-t064-MRSA-IVa, ST398-t011-MRSA-IVa, and CC6-t701-MRSA-V, were also identified. In total, 53.3% and 47.8% of isolates harbored genes for resistance to two or more classes of antimicrobial agents and two or more mobile genetic element-encoded virulence-associated factors, respectively. Effective ongoing surveillance of sporadic nosocomial MRSA is warranted for early detection of emerging clones and reservoirs of virulence, resistance, and SCCmecgenes.

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