{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:14:10Z","timestamp":1788174850902,"version":"build-2803163510"},"reference-count":36,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"unspecified","delay-in-days":258,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    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, SCC\n                    <jats:italic>mec<\/jats:italic>\n                    typing,\n                    <jats:italic>spa<\/jats:italic>\n                    typing, and detection of PVL by PCR. MLST clonal complexes (CCs) were inferred from\n                    <jats:italic>spa<\/jats:italic>\n                    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 \u201cBengal Bay\u201d 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.\n                  <\/jats:p>","DOI":"10.1017\/s0950268825100575","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T07:33:23Z","timestamp":1758008003000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Multiple highly resistant clones of MRSA circulating among patients with skin and soft tissue infection, Peshawar, Pakistan 2021\u20132022"],"prefix":"10.1017","volume":"153","author":[{"given":"Aman","family":"Ullah","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00nv6q035","id-type":"ROR","asserted-by":"publisher"}],"name":"Khyber Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorte","family":"Frees","sequence":"additional","affiliation":[{"name":"University of Copenhagen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mujahida","family":"Mansoor","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/057d2v504","id-type":"ROR","asserted-by":"publisher"}],"name":"Kohat University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shah Faisal","family":"Jamal","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00nv6q035","id-type":"ROR","asserted-by":"publisher"}],"name":"Khyber Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0892-924X","authenticated-orcid":false,"given":"Jan","family":"Tkadlec","sequence":"additional","affiliation":[{"name":"Second Faculty of Medicine and Motol University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"S0950268825100575_r17","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12705"},{"key":"S0950268825100575_r18","first-page":"568","article-title":"Epidemiology of methicillin resistant Staphylococcus aureus (MRSA) isolates from Pakistan","volume":"7","author":"Arfat","year":"2013","journal-title":"African Journal of Microbiology Research"},{"key":"S0950268825100575_r30","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000215"},{"key":"S0950268825100575_r10","volume-title":"Performance Standards for Antimicrobial Susceptibility 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Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e113"}}