The rise of antibiotic resistance genes in Staphylococcus aureus: a systematic review
DOI:
https://doi.org/10.25758/set.865Keywords:
Methicillin-resistant Staphylococcus aureus , Nosocomial infections, Antibiotic resistance genes, Virulence factors, MRSAAbstract
Introduction – Methicillin-resistant Staphylococcus aureus (MRSA) has disseminated globally, becoming endemic in many hospitals and communities. In addition to methicillin, S. aureus strains have shown resistance to other antibiotics. This resistance is conferred by genes whose presence and expression are promoted by a high rate of genetic recombination and horizontal gene transfer. The recent sequencing of the different S. aureus strains genomes and the development of bioinformatics tools hold great promise for identifying and characterizing target genes associated with this resistance. Objective – To determine emerging trends, most prevalent strains, underlying molecular mechanisms and virulence factors, and how these elements are related to antimicrobial resistance and the success of infections caused by different S. aureus clones. Methods – PubMed and ScienceDirect databases were used to search for articles published between January 2016 and August 2024 with full text available in English that investigated nosocomial infections by S. aureus, testing (AST), and genome analysis to identify antibiotic resistance genes and virulence factors. Additionally, articles from the Elicit website were also searched. The articles and information were screened using the Rayyan tool and extracted using Microsoft Excel. Results – Four studies were included, included, all of which were conducted in Asia, but in different regions. The studies conducted in China primarily focused on the two globally recognized ST239 and ST59 clones. The more localized study from Iran, carried out across five hospitals, showed a remarkable clonal distribution that reflected the local epidemiology. Meanwhile, the study from the Philippines revealed that the majority of MRSA isolates belonged to the CC30 complex, distributed mainly between the ST30 subtype and its single-locus variant ST1456. Conclusion – MRSA clonal lineage sequence types ST239 and ST59 are the most prevalent worldwide in nosocomial infections. Most studies have shown that all MRSA isolates were identified as resistant to penicillin and oxacillin. Virulence factors have concluded that the isolates carry virulence genes, with the most common being the chp and PVL coding genes.
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