Abstract
Background: Rich diversification in mobile genetic element Staphylococcus cassette chromosome (SCCmec) leads to the expansion of antibiotic resistance determinants as well as virulence factors, which is naturally designed for the stable maintenance of the core genome environment. The dissemination of SCCmec types and the virulence determinants in MRSA isolates among the hospital settings constitute a vast reservoir for displaying the potentiality for spread of infection. Methods and materials: A total of one hundred sixty one MRSA isolates were carried out for the study. All the isolates were examined for SCCmec types using multiplex PCR assay followed by sequencing of amplified products. Additionally, all the isolates bearing SCCmec types were screened for virulence determinants such as sea, seb, icaA, eta, etb, cna, fbnA and tst genes. MLST was performed for the SCCmec types bearing different virulence determinants for understanding the clonal relatedness. Results: The study confirmed the detection of SCCmec type I, type II, type III, type IV, type V, type VI, type VII, type VIII and type XII among sixty three MRSA isolates where SCCmec type II having ST1551 and type V with ST2416 were found to be associated with multidrug resistance and were highly prevalent in the study area. Virulence gene such as sea (n = 54), seb (n = 21), eta (n = 27), etb (n = 2), cna (n = 24), ica (n = 2) and tst (n = 30) were observed in the study. Thirty different combination of virulence gene with different SCCmec types were also focused in this study which helps in understanding the resistance mechanism and pathogenesis of the isolate. Conclusion: This study therefore has detected different SCCmec types with its diverse origin, source of dissemination and path of infection in this hospital setting. The routine diagnostic approach of SCCmec types among hospital isolates will be advantageous with the availability of the simplest multiplex PCR assay Thus this study will also be useful for epidemiological study as it will track the resistance along with its virulence determinants for infection control and its management
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