Arshad Faiqa, Dogar Iqbal Hussain, Jabeen Kokab, Huma Zill-E-, Tahir Romeeza, Saleem Sidrah, Tariq Waleed, Tahir Muhammad Junaid, Shaik Afsana Ansari, Asghar Muhammad Sohaib
Gujranwala Medical College, Gujranwala, Pakistan.
University of Health Sciences, Lahore, Pakistan.
Am J Trop Med Hyg. 2025 Jul 10. doi: 10.4269/ajtmh.24-0452.
This cross-sectional descriptive study was conducted at the University of Health Sciences, Lahore, over 5 years (2016-2020) to explore the association of Panton-Valentine leucocidin (pvl) genes and staphylococcal cassette chromosome mec (SCCmec) types with hospital-acquired (HA) and community-acquired methicillin-resistant Staphylococcus aureus (MRSA). Panton-Valentine leucocidin genes in MRSA have been found in HA-MRSA strains, thereby raising the prevalence of highly virulent and resistant strains. Furthermore, the usage of staphylococcal cassette chromosome mec (SCCmec) typing is crucial for understanding the epidemiology and evolution of MRSA. The isolates of Staphylococcus aureus were acquired from clinical samples of the patients. Gram staining, catalase, coagulase, and DNAse tests were used for S. aureus confirmation. The methicillin resistance genes A and C (mecA and mecC) genes were detected to confirm MRSA by using a 30 µg cefoxitin disk. Panton-Valentine leucocidin gene identification and SCCmec typing (types I-V and XI) were conducted through polymerase chain reaction testing. Only 440 strains of MRSA were isolated, and 31.6% were positive for the pvl gene. The most prevalent SCCmec type among the MRSA isolates was type III, which was found in 42.7% of isolates. The pvl gene was detected in 74% of SCCmec types IV and V and in only 14% of SCCmec types I, II, III, and IIIA. This study revealed the dynamic adaptability of MRSA strains within healthcare settings, with the cooccurrence of the pvl gene and various SCCmec types highlighting the complexity of MRSA epidemiology. The urgent implementation of comprehensive strategies that integrate molecular surveillance and infection control measures is crucial for mitigating MRSA.
这项横断面描述性研究在拉合尔健康科学大学进行，为期5年（2016 - 2020年），旨在探讨泛耐药性白细胞毒素（pvl）基因和葡萄球菌盒式染色体mec（SCCmec）类型与医院获得性（HA）及社区获得性耐甲氧西林金黄色葡萄球菌（MRSA）之间的关联。在医院获得性耐甲氧西林金黄色葡萄球菌（HA - MRSA）菌株中发现了耐甲氧西林金黄色葡萄球菌（MRSA）中的泛耐药性白细胞毒素基因，从而提高了高毒力和耐药菌株的流行率。此外，葡萄球菌盒式染色体mec（SCCmec）分型的应用对于了解耐甲氧西林金黄色葡萄球菌（MRSA）的流行病学和进化至关重要。金黄色葡萄球菌分离株取自患者的临床样本。采用革兰氏染色、过氧化氢酶、凝固酶和脱氧核糖核酸酶试验对金黄色葡萄球菌进行确认。通过使用30μg头孢西丁纸片检测甲氧西林耐药基因A和C（mecA和mecC）基因以确认耐甲氧西林金黄色葡萄球菌（MRSA）。通过聚合酶链反应试验进行泛耐药性白细胞毒素基因鉴定和SCCmec分型（I - V型和XI型）。仅分离出440株耐甲氧西林金黄色葡萄球菌（MRSA），其中31.6%的菌株pvl基因呈阳性。耐甲氧西林金黄色葡萄球菌（MRSA）分离株中最常见的SCCmec类型是III型，在42.7%的分离株中发现。在74%的SCCmec IV型和V型中检测到pvl基因，而在仅14%的SCCmec I型、II型、III型和IIIA型中检测到该基因。这项研究揭示了耐甲氧西林金黄色葡萄球菌（MRSA）菌株在医疗机构中的动态适应性，pvl基因和各种SCCmec类型的共存凸显了耐甲氧西林金黄色葡萄球菌（MRSA）流行病学的复杂性。迫切实施整合分子监测和感染控制措施的综合策略对于减轻耐甲氧西林金黄色葡萄球菌（MRSA）感染至关重要。
