Molecular Characterization and Phage Typing of Methicillin-resistant Staphylococcus aureus Isolated from Clinical Samples in Isfahan, Iran

Abstract

Background: In hospitals and communities, Methicillin-resistant Staphylococcus aureus (MRSA) plays a critical role due to its ability to acquire resistance against several antibiotics and play a role in the spread of diseases. Objectives: This research aimed to investigate the pattern of antibiotic resistance in MRSA isolates and perform molecular typing of MRSA isolates using various elements, including SCCmec type, ccr type, prophage type, and gene toxin profiles. Methods: The research spanned 20 months at Al-Zahra Hospital in Isfahan and involved 148 isolates from various anatomical sites. The isolates were evaluated for their antibiotic susceptibility patterns. They were characterized by screening for SCCmec typing, ccr typing, phage typing, and PCR profiling of pvl, hlb, sak, eta, and tst toxin genes. Results: From 148 total S. aureus isolates, 42% (n = 62) were methicillin-resistant. The MRSA isolates demonstrated substantial resistance to penicillin and ciprofloxacin, and 90.3% of MRSA isolates were multiple-drug resistant. Also, SCCmec types III, I, and IV were identified in 45.16%, 35.48%, and 19.35% of MRSA isolates, respectively. Also, seven prophage patterns and 15 toxin patterns were detected among MRSA isolates. Conclusions: Multi-drug resistance is common among MRSA isolates. The only effective drug among the investigated antibiotics was chloramphenicol. The MRSA isolates can be controlled by changing the prescribing procedure of antibiotics and applying infection control strategies. The studied MRSA isolates can cause a wide range of diseases due to having several bacteriophages that encode virulence factors. Identification of different types of prophages may be useful in predicting such pathogenic agents.