Related Experiment Video
Updated: Apr 16, 2026

Multiplex PCR Assay for Typing of Staphylococcal Cassette Chromosome Mec Types I to V in Methicillin-resistant Staphylococcus aureus
Published on: September 5, 2013
The distribution of pathogenic and toxigenic genes among MRSA and MSSA clinical isolates
Abbas Ali Imani Fooladi1, Elnaz Ashrafi2, Shafie Gorbani Tazandareh3
1Applied Microbiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Abstract:
Staphylococcus aureus (S. aureus) is considered as a notorious nosocomial pathogen among hospitalized patients and community-dwelling subjects. Its increasing morbidity and mortality is believed to be due to antibiotic resistance. However, the data concerning molecular properties of infecting strains are few. In this study, a total of 192 S. aureus strains, including 88 (45.8%) meticillin-sensitive S. aureus (MSSA) and 104 (54.2%) meticillin-resistant S. aureus (MRSA) were recovered from clinical samples. The prevalence of subtypes containing staphylococcal cassette chromosome mec (SSCmec), staphylococcal enterotoxins (SEs), toxic shock syndrome toxin (TSST) and exfoliative toxin was assessed by PCR. Antibiotic susceptibility pattern and vancomycin resistance of each isolate were evaluated by disk diffusion method and micro-dilution method, respectively. 9 (2.3%) strains required MIC > 2 mg/l of vancomycin, which significantly increased among multi drug resistant (MDR), MRSA and SCCmec type III strains (p < 0.05). 171 (89%), 140 (72.91%), 7 (3.6), 78 (48.6%), 5 (2.6%), 151 (78.64%), 129 (67.18%), 178 (92.7%) and 15 (7.8%) of 192 isolates harbored mecA, entA, entB, entC, entD, entE, eta, etb and tsst-1 genes, respectively. 31 (16.14%), 5 (2.6%), 95 (49.48%) and 7 (3.64%) of 192 isolates carried SCCmec type I, II, III and IV, respectively. We found a significantly higher rate of MRSA and resistance to all tested antibiotics, except to penicillin G, kanamycin and linezolide among the SCCmec type III class (p < 0.05). According to our findings, MSSA isolates should be taken as seriously as MRSA strains due to the potential presence of broad spectrum virulence factor genes.
Insights
This study reveals that methicillin-sensitive Staphylococcus aureus (MSSA) strains can harbor significant virulence factors, similar to methicillin-resistant S. aureus (MRSA). This highlights the need to consider MSSA as a serious threat due to its potential for causing severe infections.
Area of Science:
- Microbiology
- Infectious Diseases
- Molecular Biology
Background:
- Staphylococcus aureus is a major nosocomial pathogen.
- Antibiotic resistance contributes to its increasing morbidity and mortality.
- Limited data exists on the molecular properties of infecting S. aureus strains.
Purpose of the Study:
- To assess the prevalence of virulence factor genes and staphylococcal cassette chromosome mec (SSCmec) subtypes in clinical S. aureus isolates.
- To evaluate antibiotic susceptibility patterns and vancomycin resistance.
- To compare molecular characteristics between methicillin-sensitive S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA).
Main Methods:
- Polymerase chain reaction (PCR) was used to detect genes for staphylococcal enterotoxins (SEs), toxic shock syndrome toxin (TSST), exfoliative toxins, and SSCmec subtypes.
- Disk diffusion and micro-dilution methods were employed to determine antibiotic susceptibility and vancomycin minimum inhibitory concentrations (MICs).
Main Results:
- Out of 192 S. aureus isolates, 88 were MSSA and 104 were MRSA.
- The mecA gene was detected in 89% of isolates, and various enterotoxin genes (entA, entC, entE) were prevalent.
- SCCmec type III was associated with higher rates of MRSA and resistance to multiple antibiotics, except penicillin G, kanamycin, and linezolid.
- A small percentage (2.3%) of strains showed vancomycin MIC > 2 mg/L, notably higher in multi-drug resistant (MDR), MRSA, and SCCmec type III strains.
Conclusions:
- MSSA isolates can carry significant virulence factor genes, posing a threat comparable to MRSA.
- SCCmec type III strains exhibit increased antibiotic resistance.
- Clinical vigilance is necessary for both MSSA and MRSA due to their diverse molecular profiles and resistance patterns.
Related Concept Videos
Clinical Significance of Antibiotic Resistance
Mechanism of Antibiotic Resistance in MRSA
Modern Molecular Taxonomy
Staphylococcal Skin Infections
Bacterial Gastroenteritis
Applications of Molecular Taxonomy

