Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a serious public health problem. There is limited information regarding the genetics of MRSA strains among the native Iraqi and incoming Syrian refugee communities. We aimed to characterize the genotypes and different virulence factors of MRSA in strains isolated from these two communities. Frozen MRSA strains (125) isolated from the native Iraqi and Syrian refugee communities were used in this study. PCR (singleplex and multiplex) and agr typing was used for the genotypic analysis of different virulence genes. We tested for the presence of virulence genes including pvl, arcA, tst, lukE/lukD, hla, hlb, eta, etb and agr. Prevalence of arcA MRSA in the Iraqi community (56.58%) was significantly higher (p = 0.008) than that in the Syrian refugee community (32.66%). Prevalence of lukE-lukD was also significantly higher (p = 0.001) in the Iraqi (82.89%) compared to that in the Syrian refugee community (57.14%). Further, prevalence of hla MRSA in the Iraqi community was (93.4%) and in the Syrian refugee community was (71.4%); (p = 0.0008). No significant differences were observed in the prevalence of pvl, tst, eta, etb and hlb. The most dominant agr types in both Iraqi (76.1% and 10.5%) and Syrian refugee (44.9% and 18.37%) communities were I and III. To sum up, no significant differences were observed between the groups for a majority of virulence factors. This is the first investigation of MRSA genotypes and virulence in both these communities. These results could be useful for further studies that assess the genetic relatedness of strains in the region for epidemiological and monitoring purposes, which would be crucial to limiting the spread of MRSA.
Highlights
Staphylococcus aureus is a gram-positive commensal bacterium that commonly inhabits different parts of the body including nostrils and axilla [1]
The isolates were tested for oxacillin susceptibility and their identity was confirmed to be Methicillin-resistant Staphylococcus aureus (MRSA) by Polymerase chain reaction (PCR) for mecA and Staphylococcal genus- specific 16s rRNA genes
The prevalence rate (Table 2) for arcA in the native Iraqi community (56.58%) was significantly higher than (p = 0.008) that in the Syrian refugee community (32.66%)
Summary
Staphylococcus aureus is a gram-positive commensal bacterium that commonly inhabits different parts of the body including nostrils and axilla [1]. MRSA toxins play a role during infections and conditions such as toxic shock syndrome [4, 6] staphylococcal scarlet fever, staphylococcal scalded-skin syndrome, and food poisoning [6]. Different virulence factors that are encoded by different genes play a major role during pathogenesis. Such factors include panton-valentine leucocidin toxins (PVL, encoded by lukS/F-PV and lukE/D genes) [5, 7, 8], exfoliative toxins (etb and eta), arginine catabolic mobile element (ACME, arcA), beta-hemolysin (hlb), toxic shock syndrome toxin-1 (TSST-1, tst) and accessory gene regulator (agr) [6, 7] and alpha-hemolysin (hla) [6]
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