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Low Panton-Valentine leukocidin prevalence in circulating community MRSA: a genomic surveillance study in Qatar
Ristha Kamar1, Khaloud J Alobaidli2, Alyaa N Al Nuaimi2
1Biomedical Research Centre, QU Health Sector, Qatar University, Doha, 2713, Qatar.
Background:
Staphylococcus aureus (S. aureus), particularly methicillin-resistant S. aureus (MRSA), is a major human pathogen causing severe infections. While well studied in hospitals, limited data exist on the transmission and antimicrobial resistance (AMR) profiles of community-associated MRSA (CA-MRSA) in the Gulf region. This study investigated the AMR patterns of CA-MRSA.
Methods:
Nasal and axillary swabs from 576 asymptomatic residents of Qatar without a history of hospitalization, surgery, dialysis, or indwelling medical devices in the preceding 12 months, and those who have not used antibiotics within the previous 3 months were analyzed. S. aureus was isolated on mannitol salt agar, confirmed by VITEK® 2 Compact, and methicillin resistance was determined by cefoxitin disc diffusion. AMR profiling followed CLSI guidelines. PCR and whole-genome sequencing using the GridION platform were performed for molecular confirmation and genomic characterization, including gene annotation and phylogenetic analysis. All sequences were deposited in NCBI.
Results:
Of 60 confirmed S. aureus isolates (10.4% prevalence), 35% (n = 21) were MRSA, yielding an overall MRSA carriage prevalence of 3.6% (21/576). Most MRSA isolates came from young asymptomatic individuals aged 18 to 45 (80%, 17/21) and from men (58%, 12/21). Among the 21 MRSA isolates identified in this cohort, resistance rates were 29% for erythromycin and ciprofloxacin, 24% for tetracycline, 14% for gentamicin, and 10% for sulfonamides. A total of 71% of the isolates exhibited multidrug resistance. All MRSA isolates carried the methicillin resistance gene (mecA), while 4.7% harbored the Panton-Valentine leukocidin (PVL) gene. Phylogenetic analysis revealed four distinct clusters, indicating a polyclonal community rather than a single spreading strain.
Conclusions:
The prevalence of multidrug-resistant MRSA with key virulence factors may represent a continuing public health concern, underscoring the need for strengthened community surveillance, antimicrobial stewardship, and infection control to monitor and limit the spread of multiple circulating strains.
Insights
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is prevalent in Qatar, with many strains showing multidrug resistance and key virulence factors. Enhanced surveillance is needed to control the spread of these diverse MRSA strains.
Area of Science:
- Microbiology
- Infectious Diseases
- Genomics
Background:
- Staphylococcus aureus (S. aureus), especially methicillin-resistant strains (MRSA), are significant pathogens.
- Limited data exists on community-associated MRSA (CA-MRSA) transmission and antimicrobial resistance (AMR) in the Gulf region.
Purpose of the Study:
- To investigate the AMR patterns and genomic characteristics of CA-MRSA in asymptomatic residents of Qatar.
Main Methods:
- Analysis of nasal and axillary swabs from 576 asymptomatic individuals.
- Isolation and confirmation of S. aureus, followed by methicillin resistance determination.
- Antimicrobial resistance profiling, PCR, and whole-genome sequencing for molecular and genomic characterization.
Main Results:
- Prevalence of S. aureus was 10.4%, with MRSA carriage at 3.6% (21/576 isolates).
- Most MRSA isolates were from young, asymptomatic men; resistance was observed for erythromycin, ciprofloxacin, tetracycline, gentamicin, and sulfonamides.
- 71% of MRSA isolates exhibited multidrug resistance; 4.7% carried the Panton-Valentine leukocidin (PVL) gene. Phylogenetic analysis indicated polyclonal MRSA strains.
Conclusions:
- The presence of multidrug-resistant MRSA with virulence factors poses a public health concern.
- Strengthened community surveillance, antimicrobial stewardship, and infection control are crucial to monitor and limit the spread of diverse MRSA strains.
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