Multiple highly resistant clones of MRSA circulating among patients with skin and soft tissue infection, Peshawar, Pakistan 2021-2022.

IF 2.2 4区医学 Q3 INFECTIOUS DISEASES

Epidemiology and Infection Pub Date : 2025-09-16 DOI:10.1017/S0950268825100575

Aman Ullah, Dorte Frees, Mujahida Mansoor, Shah Faisal Jamal, Jan Tkadlec

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Abstract

We aimed to determine the prevalence of antimicrobial resistance, carriage of Panton-Valentine leucocidin (PVL), and the clonal structure of MRSA isolates collected from skin and soft tissue infections at a tertiary care hospital in Pakistan. Between August 2021 and May 2022, 154 non-repetitive MRSA isolates were consecutively collected and characterized by antimicrobial susceptibility testing, SCCmec typing, spa typing, and detection of PVL by PCR. MLST clonal complexes (CCs) were inferred from spa type using the Based Upon Repeat Pattern (BURP) algorithm. High levels of resistance were observed to ciprofloxacin (85.7%), erythromycin (76.0%), sulfamethoxazole (68.8%), gentamicin (68.8%), fusidic acid (57.8%), tetracycline (55.8%), and clindamycin (42.2%). Clonal analysis revealed 16 lineages, with the most frequent being CC8-MRSA-IV (27.3%), PVL-positive "Bengal Bay" CC1/ST772-MRSA-V (26.0%), and CC1-MRSA-IV (16.2%). PVL was detected in 45.5% of isolates across multiple lineages. Our findings highlight the coexistence of high antimicrobial resistance and frequent PVL carriage among MRSA in Pakistan. Given the association of PVL with severe infections and the limited treatment options for multidrug-resistant strains, these data underscore a significant public health concern and the need for systematic surveillance and prudent antibiotic use.

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2021-2022年，巴基斯坦白沙瓦，皮肤和软组织感染患者中流行的多重高耐药MRSA克隆。

我们的目的是确定抗菌药物耐药性的流行程度、潘顿-瓦伦丁嗜白细胞素（PVL）的携带情况以及从巴基斯坦一家三级保健医院皮肤和软组织感染中收集的MRSA分离株的克隆结构。于2021年8月至2022年5月，连续收集非重复MRSA分离株154株，进行药敏试验、SCCmec分型、spa分型及PCR检测PVL。利用基于重复模式（BURP）算法从spa型推断出MLST克隆复合物（CCs）。对环丙沙星（85.7%）、红霉素（76.0%）、磺胺甲新唑（68.8%）、庆大霉素（68.8%）、福西地酸（57.8%）、四环素（55.8%）、克林霉素（42.2%）耐药程度较高。克隆分析显示16个谱系，最常见的是CC8-MRSA-IV (27.3%)， pvl阳性的“Bengal Bay”CC1/ST772-MRSA-V（26.0%）和CC1- mrsa - iv（16.2%）。45.5%的分离株在多个谱系中检测到PVL。我们的研究结果强调了在巴基斯坦MRSA中共存的高抗菌素耐药性和频繁的PVL携带。鉴于PVL与严重感染的关联以及对多药耐药菌株的有限治疗选择，这些数据强调了一个重大的公共卫生问题以及系统监测和谨慎使用抗生素的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Epidemiology and Infection 医学-传染病学

CiteScore

4.10

自引率

2.40%

发文量

366

审稿时长

3-6 weeks

期刊介绍： Epidemiology & Infection publishes original reports and reviews on all aspects of infection in humans and animals. Particular emphasis is given to the epidemiology, prevention and control of infectious diseases. The scope covers the zoonoses, outbreaks, food hygiene, vaccine studies, statistics and the clinical, social and public-health aspects of infectious disease, as well as some tropical infections. It has become the key international periodical in which to find the latest reports on recently discovered infections and new technology. For those concerned with policy and planning for the control of infections, the papers on mathematical modelling of epidemics caused by historical, current and emergent infections are of particular value.