Molecular characterization of methicillin-resistant Staphylococcus aureus isolated from tertiary care hospitals

ABSTRACT

Methicillin-resistant S. aureus [MRSA] tends to be resistant to multiple antibiotics. Methicillin resistance is conferred by the acquisition of the mecA gene, which is carried by a mobile genetic element called the staphylococcal cassette chromosome mec [SCCmec]. There are five major types of SCCmec elements [I-V]. The majority of hospital-acquired MRSA [HA-MRSA] strains carry SCCmec types I, II, or III, whereas community-acquired MRSA [CA-MRSA] strains carry SCCmec types IV or V. In addition, Panton-Valentine Leucocidin [PVL] is a gene encoding a powerful cytotoxin that is strongly associated with CA-MRSA strains. The present study was aimed to identify the types of SCCmec and PVL genes among clinical MRSA isolates. This study was conducted in 5 tertiary care hospitals in Makkah city from March to September of 2012. A total of 206 S. aureus clinical isolates were analysed using standard microbiological methods. Multiplex PCR was performed on genomic DNA from MRSA isolates in order to identify the types of SCCmec. In addition, PCR was performed to detect the PVL gene among the isolates. Of the 206 S. aureus isolates, 114 [55.3%] were MRSA, and 100 of the MRSA isolates carried the mecA gene. Results from SCCmec typing revealed that 3% were type I; 9% were type II; 47% were type III, and 29% were type IV. Nineteen per cent of the isolates harboured the PVL gene. Furthermore, there was a statistically significant correlation between the presence of the PVL gene and SCCmec type IV. The virulence of MRSA strains is increasing in both hospital and community settings in Makkah, highlighting the importance of their rapid identification in order to appropriately control infection