Molecular Characterization of Staphylococcus aureus Isolates Associated with Nasal Colonization and Environmental Contamination in Academic Dental Clinics

Aim: To determine the genetic makeup of methicillin-sensitive/methicillin-resistant Staphylococcus aureus (MSSA/MRSA) from nasal colonization and environmental contamination in dental clinics. Materials and Methods: Nasal swabs from students and health care workers and environmental swabs were obtained at two academic dental clinics in the United Arab Emirates. The StaphyType DNA microarray-based assay was used for molecular characterization. Results: Forty-eight S. aureus isolates were identified phenotypically (nasal: n = 43; environmental: n = 5), but 6 of these were assigned to S. argenteus by genotyping. These were CC (argenteus) 2596, CC (arg) 2250-MSSA, CC (arg) 2250-MSSA-(Panton Valentine leukocidin [PVL]+) ( n = 2), and CC (arg) 2198-MSSA ( n = 2). MRSA nasal colonization rate was 5.4% (n/ N = 8/146) with the following strain affiliations: CC5-MRSA-[IV+ fus + ccrAB ], “Maltese Clone”; CC6-MRSA-IV, “WA MRSA-51”; CC22-MRSA-IV (PVL+/ tst+ ); CC22-MRSA-[IV+ fus+ccrAA/(C) ]; and two each of CC5-MRSA-[VI+ fus ] and CC97-MRSA-[V/VT+ fus ]. The SCC-borne fusidic acid resistance ( fusC ) gene was detected in MRSA ( n = 5) and MSSA ( n = 1). Some MSSA strains, CC1-MSSA-[ fus + ccrAB1 ] and ST1278-MSSA-[ ccrA1 ], harbored recombinase genes. A CC30-MSSA harbored ACME locus/ arc -genes, while ST1278-MSSA-[ ccrA1 ] had an ACME-III element. Enterotoxin genes were commonly carried, but tst-1 gene was found in only CC22, CC30, and CC34 strains, while pvl genes were identified in CC ( arg ) 2250 and CC22-MRSA-IV. Of the 51 noncoagulase staphylococci (CoNS) identified, 18 were mecA positive. Conclusion: The findings demonstrate the first report of rare strains (ST1278 MSSA, CC ( arg ) 2198, CC ( arg ) 2596, and PVL+CC ( arg ) 2250) in our region. Detection of MSSA with recombinase genes and ACME loci alongside mecA -positive CoNS is of clinical significance as this could provide a milieu for acquisition and transfer of SCC-elements, either with different ACME types, with fusC or the mecA gene resulting in conversion of MSSA into MRSA.