Molecular Detection of Hospital-Acquired Methicillin-Resistant Staphylococcusaureus Isolated From Teaching Hospitals in Damascus, Syria

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is an established pathogen responsible for hospital-acquired infections (HAIs). Accurate MRSA diagnosis is of paramount importance to facilitate early and effective treatment and to manage its transmission effectively. The primary objective of our study was to determine the precise prevalence of hospital-acquired MRSA (HA-MRSA) in select teaching hospitals in Damascus by detecting the presence of the mecA gene. Methods: One hundred Staphylococcus aureus isolates were collected from various clinical specimens obtained from inpatients admitted to three major teaching hospitals in Damascus, Syria, including Al-Moussat, Al-Assad, and Tishreen Military Hospitals. These patients met the established criteria for HAIs. The isolates were collected between December 2021 and August 2022. Genus and species confirmation were conducted via polymerase chain reaction (PCR), employing the 16SrDNA gene specific to the Staphylococcus genus and the nuc gene specific to S. aureus. Methicillin resistance was assessed using cefoxitin disc diffusion (CDD) in accordance with Clinical and Laboratory Standards Institute (CLSI) recommendations. The presence of the mecA gene was also detected through PCR. Results: Out of the collected isolates, 67% exhibited resistance to cefoxitin, as determined by the CDD, while 66% were found to be positive for the mecA gene. CDD demonstrated a sensitivity of 100% and a specificity of 97%. Conclusion: This investigation revealed a notably high incidence of HA-MRSA infections within the teaching hospitals under scrutiny. The CDD method displayed significant sensitivity and specificity, making it a dependable alternative to the mecA PCR for MRSA detection. This finding holds substantial importance for the effective implementation of infection control initiatives and strategies aimed at eradicating MRSA and curtailing its spread within our hospital facilities.