Panton-Valentine Leukocidin (PVL) genes may not be a reliable marker for community-acquired MRSA in the Dakahlia Governorate, Egypt

Abstract

Background Methicillin-resistant Staphylococcus aureus is linked to both nosocomial and community infections. One of the key virulence factors of S. aureus is Panton-Valentine leukocidin (PVL). The PVL genes are mostly associated with community-acquired MRSA (CA-MRSA). This study evaluates the prevalence of PVL genes as a marker for CA-MRSA at tertiary hospitals in Mansoura, Dakahlia, Egypt. S. aureus was isolated from clinical specimens obtained from different departments of tertiary hospitals, outpatient clinics, and hospital healthcare workers (HCWs). PCR was used to detect the mecA, PVL, and SCCmec genes among the recovered isolates. Standard broth microdilution method was used to determine the minimum inhibitory concentrations (MIC) of nine antibiotics against S. aureus. Results Two hundred S. aureus isolates were recovered and identified out of the total isolates (n = 320). The mecA gene was detected in 103 S. aureus isolates (51.5%). Among the MRSA isolates, 46.60% were PVL-positive. The incidence of the PVL genes of MRSA in nosocomial (HA), outpatient clinics (CA), and HCWs was 46.66%, 56.52%, and 42%, respectively. All MRSA isolates showed resistance to cefoxitin. The percentage of resistance to most tested antibiotics was high, except for ciprofloxacin (6.85%). Both antibiotic resistance and multidrug resistance among MRSA isolates were generally higher in PVL-positive isolates than in PVL-negative isolates in HA- and CA-MRSA isolates. While SCCmec type V was the most prevalent in PVL-positive MRSA stains, type I was the most prevalent in PVL-negative isolates. Conclusion This study revealed that PVL genes are generally highly prevalent among mecA-positive MRSA isolates, whether they are CA-MRSA, HA-MRSA, or HCW isolates. Therefore, PVL is not a valid marker for CA-MRSA in Mansoura, Dakahlia Governorate, Egypt, as has been reported in other countries. Further epidemiologic studies are required to track the incidence of PVL in HA-MRSA, CA-MRSA, and HCW isolates in other Egyptian governorates.

Prevalence, Virulence Determinants and Antimicrobial Resistance Genes of Staphylococcus aureus Strains Isolated from Retail Market Fish and Their Handlers in Egypt

“…On the other hand, our research revealed that pvl gene was present in all S. aureus isolates. Therefore, our findings suggest that fish handlers could be the potential source of S. aureus contamination in the tested fish specimens since pvl gene was originally and commonly associated with community-acquired MRSA (CA-MRSA) isolates and was infrequently identified in hospital-acquired MRSA (HA-MRSA) isolates (Shohayeb et al, 2023). Moreover, only one isolate contained tst gene which encodes TSST-1 protein, and this protein is a crucial virulence determinant of S. aureus leading to a multiple organ dysfunction (Zheng et al, 2020).…”

Antibiotic resistance pattern of Methicillin-resistant Staphylococcus aureus isolated from hospitalized patients

“…According to the comparison of antibiotic resistance patterns among MRSA isolates from teaching hospitals [26,27].…”