{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:08:11Z","timestamp":1777932491165,"version":"3.51.4"},"reference-count":75,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Institute of Health, USA","award":["P01 AI083214"],"award-info":[{"award-number":["P01 AI083214"]}]},{"DOI":"10.13039\/501100004681","name":"Higher Education Commission, Pakistan","doi-asserted-by":"crossref","award":["NRPU grant-Project No. 2018"],"award-info":[{"award-number":["NRPU grant-Project No. 2018"]}],"id":[{"id":"10.13039\/501100004681","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Staphylococcus aureus<\/jats:title>\n                    <jats:p>\n                      is a critical global health threat due to its multidrug resistance (MDR) and virulence. We examined the relationship between MDR and virulence in 250 clinical\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      isolates using the\n                      <jats:italic toggle=\"yes\">Galleria mellonella<\/jats:italic>\n                      infection model. Alpha-hemolysin was the most prevalent toxin, with its gene,\n                      <jats:italic toggle=\"yes\">hla<\/jats:italic>\n                      , present in the majority of hemolytic strains. Other virulence genes, including\n                      <jats:italic toggle=\"yes\">sigB, codY, fnbA, fnbB, clfA, saeS, sarA, arlS, yycG, spoVG, rot,<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">PVL<\/jats:italic>\n                      , were widely distributed across methicillin-resistant\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      (MRSA) and methicillin-sensitive\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      (MSSA) isolates. The\n                      <jats:italic toggle=\"yes\">ica<\/jats:italic>\n                      gene showed a notable increase in expression in hospital-acquired (HA-MRSA) and community-acquired (CA-MRSA) strains. In vivo infections revealed that HA-MRSA strains were more virulent than vancomycin intermediate\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      VISA, CA-MRSA, MSSA, and an agr mutant strain, while locally sourced CA-MRSA exhibited the highest virulence among tested strains. Despite differences in antibiotic resistance, MRSA and MSSA shared largely similar virulence gene profiles. These findings highlight the complex interplay between MDR and virulence in\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      and emphasize the need for further mechanistic studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Importance:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      remains a major clinical concern due to its increasing multidrug resistance (MDR) and virulence. Understanding the relationship between resistance mechanisms and virulence is essential for guiding effective treatment and infection control. This study assessed the virulence potential of 250 MDR\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      isolates using a clinically relevant invertebrate model (\n                      <jats:italic toggle=\"yes\">G. mellonella<\/jats:italic>\n                      ), revealing key virulence gene profiles. Notably, CA-MRSA strains exhibited hypervirulence, with alpha-hemolysin as the most prevalent toxin and significant upregulation of the\n                      <jats:italic toggle=\"yes\">ica<\/jats:italic>\n                      gene in both CA- and HA-MRSA isolates. These findings emphasize the growing threat of CA-MRSA and the importance of integrated surveillance of both resistance and virulence in\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      populations.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10766294261426723","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T06:34:07Z","timestamp":1773902047000},"page":"158-171","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Virulence Profiling of Multidrug-Resistant Clinical\n                    <i>Staphylococcus aureus<\/i>\n                    Isolates"],"prefix":"10.1177","volume":"32","author":[{"given":"Amir Afzal","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Medical Laboratory Technology, Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan."},{"name":"Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan."},{"name":"Infectious Disease Division, Department of Medicine, Rhode Island Hospital and Alpert Medical School of Brown University, Providence, Rhode Island, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamna","family":"Sadaf","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rabaab","family":"Zahra","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan."},{"name":"Department of Clinical Microbiology, School of Medicine, Trinity College Dublin, St James\u2019s Hospital, Dublin, Ireland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6107-3754","authenticated-orcid":false,"given":"Nagendran","family":"Tharmalingam","sequence":"additional","affiliation":[{"name":"Infectious Disease Division, Department of Medicine, Rhode Island Hospital and Alpert Medical School of Brown University, Providence, Rhode Island, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleftherios","family":"Mylonakis","sequence":"additional","affiliation":[{"name":"Infectious Disease Division, Department of Medicine, Rhode Island Hospital and Alpert Medical School of Brown University, Providence, Rhode Island, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00134-14"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/mec.13474"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/mmi.12893"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro3521"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0132949"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mib.2013.11.004"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1001036"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.4161\/viru.2.5.17724"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20050846"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.genet.42.110807.091640"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens11111262"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1021\/acs.biomac.0c00147"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chom.2017.10.006"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/mmi.13634"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.00358-15"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1086\/596511"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.191267598"},{"issue":"70","key":"e_1_3_4_19_2","first-page":"e4392","article-title":"The insect Galleria mellonella as a powerful infection model to investigate bacterial pathogenesis","author":"Ramarao N","year":"2012","unstructured":"Ramarao N, , Nielsen-Leroux C, , Lereclus D. 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