Diagnostics (Jun 2023)

Community-Acquired Methicillin-Resistant <i>Staphylococcus aureus</i> in Hospitals: Age-Specificity and Potential Zoonotic–Zooanthroponotic Transmission Dynamics

  • Ahmed Alsolami,
  • Naif Saad ALGhasab,
  • Mohammed S. M. Alharbi,
  • Abdelhafiz I. Bashir,
  • Mohd Saleem,
  • Azharuddin Sajid Syed Khaja,
  • Dakheel F. Aldakheel,
  • Ehab Rakha,
  • Jabar Aziz Alshammari,
  • Taha E. Taha,
  • Ziyad Melibari,
  • Yaseer H. Alharbi,
  • Ali A. Almutlag,
  • Kamaleldin B. Said

DOI
https://doi.org/10.3390/diagnostics13122089
Journal volume & issue
Vol. 13, no. 12
p. 2089

Abstract

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Methicillin-resistant Staphylococcus aureus (MRSA) lineages are a devastating clinical and public health issue. Data on local lineage profiles are limited. We report on the frequency of community-acquired and hospital-acquired cases (CA-MRSA, HA-MRSA). We studied 147 isolates from King Khalid tertiary care hospitals (KKH), each from a case in a patient and including 33 patients at the Maternity and Children’s Hospital (MCH). Of the 147 isolates, 87 males (59%) and 60 females (41%) were in KKH. The overwhelming majority (80%; n = 119/147) were CA-MRSA in KKH. Intriguingly, despite significant differences between males (70%) and females (53%), lineage-acquisition remained age-specific around 58–60 years in both genders. However, while CA-MRSA dominated early in life (0–20, 70% MCH), it increased with age in KKH adults; 21–50 (28%), >50 (59%) until the overall 80% (n = 144/180). Major specimens included skin-wounds, surgeries (70.3%), blood (13.5%), sputum (8.8%), very rarely urine (4.1%), and nasal (3.4%), albeit most patients showed severe enteritis and necrotizing pneumonia. Antibiograms showed high beta lactam resistances, including amoxicillin–clavulanate (83%), oxacillin (84%), cefoxitin FOX (100%), penicillin and ampicillin (~100%), as well as high resistance (82%) to carbapenem. Fortunately, high susceptibility was seen to non-beta lactams and, to a lesser extent, gentamicin, erythromycin, and fusidic acid; 33%, 34%, and 38%, respectively, in KKH. A similar pattern was seen in MCH except for a low resistance pattern to gentamicin CN, clindamycin CD, erythromycin E, and tobramycin TOB; 34%, 31%, 39%, and 41%, respectively, except for fusidic acid. These findings have significant clinical implications for MRSA patient management strategies. Clinical- and lineage-profiles imply host-selection and zoonotic–zooanthroponotic transmission dynamics. Future molecular typing, sequencing, and characterization of dominant clone(s) is imperative.

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