Molecular Investigation and Virulence Determination of Methicillin and Vancomycin Resistant Clinical Staphylococcus Aureus Isolates.

Staphylococcus aureus is an opportunistic pathogen that provides conditions for host invasion due to various virulence factors and plays a role in causing various infections. The pathogenicity of these bacteria may vary depending on the host's susceptibility. This study investigates the sensitivity of S. aureus strains isolated from clinical samples to methicillin and vancomycin, and it evaluates the presence of resistance, virulence and toxin-producing genes, and their expression level in the methicillin-resistant S. aureus (MRSA), vancomycin-resistant S. aureus (VRSA), and vancomycin-intermediate S. aureus (VISA) isolates. A cross-sectional study was conducted, encompassing 502 S. aureus isolates obtained from diverse infections over the course of a year. The methicillin and vancomycin sensitivities of the isolates were ascertained by disk diffusion and microdilution broth methods, respectively. The presence of genes associated with resistance, adhesion, and toxin production was subsequently investigated through the implementation of multiplex polymerase chain reaction (PCR) methodology. The expression levels of virulence and resistance genes were detected in resistant and sensitive isolates using real-time quantitative PCR (qPCR). Among the 502 S. aureus isolates, 168 (33.6%) were identified as MRSA. Furthermore, a total of six isolates (1.2%) were identified as VRSA, and two isolates (0.4%) were identified as VISA. The distribution of virulence and resistance-related genes varied among the isolates. The results of the gene expression study demonstrated that the expression levels of the majority of the studied genes were significantly higher in resistant isolates (MRSA and VRSA) compared to sensitive isolates. It is imperative to acknowledge that VRSA and MRSA are regarded as grave hazards to human health. The present study underscores the necessity for enhanced sanitary measures to more effectively control this hospital pathogen, particularly in light of the presence and expression of genes encoding virulence factors in S. aureus isolates.