{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:28:14Z","timestamp":1793413694294,"version":"4.5.0"},"reference-count":71,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T00:00:00Z","timestamp":1637193600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007356","name":"M\u00e9diterran\u00e9e Infection Foundation","doi-asserted-by":"publisher","award":["10-IAHU-03"],"award-info":[{"award-number":["10-IAHU-03"]}],"id":[{"id":"10.13039\/100007356","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>In this paper, we investigate the epidemiology of infections-associated Staphylococcusaureus (S. aureus) from the Medical Intensive Care Unit (MICU) at University Hospital Center of Constantine (UHCC) in Algeria, with a special emphasis on methicillin-resistant strains (MRSA) revealed by cefoxitin disks (30 \u03bcg), then confirmed by penicillin-binding protein (PBP2a) agglutination and real-time polymerase chain reaction (RT-PCR) targeting mecA and mecC genes. Staphylococcal Cassette Chromosome mec (SCCmec type), staphylococcal protein A (spa-type), multilocus sequence type (MLST), Panton\u2013Valentine Leucocidin (PVL), and toxic shock syndrome toxin-1 (TSST-1) were further investigated in all isolates, and whole genome sequencing was performed for a selected subset of three hospital-acquired MRSA (HA-MRSA) isolates. A measurement of 80% out of the 50 S. aureus isolates were identified as HA-MRSA harbouring the mecA gene, and 72.5% of them were multidrug resistant (MDR). Twelve STs, four different SCCmec cassettes, fourteen spa types, ten isolates Panton\u2013Valentine Leukocidin (PVL)-positive, and three isolates TSST-1 were identified. Interestingly, there was a high prevalence (n = 29; 72.5%) of a worrisome emerging clone: the HA-MRSA ST239\/241 SCCmec-III mercury with PVL negative, resistant to \u03b2-lactams, aminoglycosides, quinolones, and tetracyclines. Other clones of HA-MRSA isolates were also identified, including PVL-positive ST80 SCCmec-IV\/SCCmec-unknown (22.5%), ST34 SCCmec-V with TSST-1 positive (2.5%), and PVL-negative ST72 SCCmec-II (2.5%). Genome analysis enables us to describe the first detection of both PVL-negative HA-MRSA ST239\/241 SCCmec-III mercury carrying ccrC, as well as SCCmec-V cassette, which dramatically changes the epidemiology of S. aureus infections in one of the hospitals in eastern Algeria.<\/jats:p>","DOI":"10.3390\/pathogens10111503","type":"journal-article","created":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T02:43:09Z","timestamp":1637289789000},"page":"1503","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Emergence of Methicillin-Resistant Staphylococcus aureus ST239\/241 SCCmec-III Mercury in Eastern Algeria"],"prefix":"10.3390","volume":"10","author":[{"given":"Hanane","family":"Aouati","sequence":"first","affiliation":[{"name":"D\u00e9partement de Microbiologie, Facult\u00e9 des Sciences de la Nature et de la Vie, Universit\u00e9 des Fr\u00e8res Mentouri Constantine 1, Constantine 25017, Algeria"},{"name":"MEPHI, IRD, APHM, IHU-M\u00e9diterran\u00e9e Infection, Facult\u00e9 de Pharmacie, Aix-Marseille Universit\u00e9, 13005 Marseille, France"},{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 Salah Boubnider Constantine 3, Centre Hospitalo-Universitaire Ben Badis, Service de Microbiologie, BP 125, Constantine 25000, Algeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Hadjadj","sequence":"additional","affiliation":[{"name":"MEPHI, IRD, APHM, IHU-M\u00e9diterran\u00e9e Infection, Facult\u00e9 de Pharmacie, Aix-Marseille Universit\u00e9, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farida","family":"Aouati","sequence":"additional","affiliation":[{"name":"D\u00e9partement d\u2019Anesth\u00e9sie-R\u00e9animation Chirurgicale, Universit\u00e9 Paris Nord, APHP, H\u00f4pital Beaujon, 92110 Clichy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Agabou","sequence":"additional","affiliation":[{"name":"Institut V\u00e9t\u00e9rinaire, Universit\u00e9 des fr\u00e8res Mentouri Constantine 1, Laboratoire de Recherche PADESCA, Constantine 25071, Algeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7670-9620","authenticated-orcid":false,"given":"Mariem","family":"Ben Khedher","sequence":"additional","affiliation":[{"name":"MEPHI, IRD, APHM, IHU-M\u00e9diterran\u00e9e Infection, Facult\u00e9 de Pharmacie, Aix-Marseille Universit\u00e9, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hac\u00e8ne","family":"Bousseboua","sequence":"additional","affiliation":[{"name":"Ecole de Biotechnologie, Universit\u00e9 Salah Boubnider Constantine 3, Laboratoire de G\u00e9nie Microbiologique, BP E66, Constantine 25000, Algeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chafia","family":"Bentchouala","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 Salah Boubnider Constantine 3, Centre Hospitalo-Universitaire Ben Badis, Service de Microbiologie, BP 125, Constantine 25000, Algeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Marc","family":"Rolain","sequence":"additional","affiliation":[{"name":"MEPHI, IRD, APHM, IHU-M\u00e9diterran\u00e9e Infection, Facult\u00e9 de Pharmacie, Aix-Marseille Universit\u00e9, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6466-2324","authenticated-orcid":false,"given":"Seydina M.","family":"Diene","sequence":"additional","affiliation":[{"name":"MEPHI, IRD, APHM, IHU-M\u00e9diterran\u00e9e Infection, Facult\u00e9 de Pharmacie, Aix-Marseille Universit\u00e9, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1128\/CMR.00134-14","article-title":"Staphylococcus aureus infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management","volume":"28","author":"Tong","year":"2015","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1146\/annurev-pathol-012615-044351","article-title":"Pathogenesis of Staphylococcus aureus Bloodstream Infections","volume":"11","author":"Thomer","year":"2016","journal-title":"Annu. Rev. Pathol. Mech. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1080\/21505594.2017.1335847","article-title":"What is behind the epidemiological difference between community-acquired and health-care associated methicillin-resistant Staphylococcus aureus?","volume":"8","author":"Figueiredo","year":"2017","journal-title":"Virulence"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1101\/gr.147710.112","article-title":"A genomic portrait of the emergence, evolution, and global spread of methicillin-resistant Staphylococcus aureus pandemic","volume":"23","author":"Holden","year":"2013","journal-title":"Genome Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13104-017-2695-5","article-title":"Nosocomial bacterial infections and their antimicrobial susceptibility patterns among patients in Ugandan intensive care units: A cross sectional study","volume":"10","author":"Agaba","year":"2017","journal-title":"BMC Res. Notes"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1128\/jb.158.2.513-516.1984","article-title":"Low-Affinity Penicillin-Binding Protein Associated with \u03b2-Lactam Resistance in Staphylococcus aureus","volume":"158","author":"Hartman","year":"1984","journal-title":"J. Bacteriol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1128\/AAC.44.6.1549-1555.2000","article-title":"A New Class of Genetic Element, Staphylococcus Cassette Chromosome mec, Encodes Methicillin Resistance in Staphylococcus aureus","volume":"44","author":"Katayama","year":"2000","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1128\/JCM.00068-17","article-title":"Detection of mecC -Positive Staphylococcus aureus: What To Expect from Immunological Tests Targeting PBP2a?","volume":"55","author":"Dupieux","year":"2017","journal-title":"J. Clin. Microbiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"4961","DOI":"10.1128\/AAC.00579-09","article-title":"Classification of staphylococcal cassette chromosome mec (SCCmec): Guidelines for reporting novel SCCmec elements","volume":"53","author":"Ito","year":"2009","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"7597","DOI":"10.1128\/AAC.01692-15","article-title":"Novel type XII staphylococcal cassette chromosome mec harbouring a new cassette chromosome recombinase, CcrC2","volume":"59","author":"Wu","year":"2015","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.meegid.2018.03.013","article-title":"Novel SCCmec type XIII (9A) identified in an ST152 methicillin-resistant Staphylococcus aureus","volume":"61","author":"Baig","year":"2018","journal-title":"Infect. Genet. Evol."},{"key":"ref_12","first-page":"46","article-title":"Novel staphylococcal cassette chromosome mec (SCCmec) type XIV (5A) and a truncated SCCmec element in SCC composite islands carrying speG in ST5 MRSA in Japan","volume":"75","author":"Urushibara","year":"2019","journal-title":"J. Antimicrob. Chemtherapy"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1111\/j.1469-0691.2006.01573.x","article-title":"The molecular evolution of methicillin-resistant Staphylococcus aureus","volume":"13","author":"Deurenberg","year":"2007","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.mcp.2012.04.002","article-title":"Enhanced multiplex PCR assay for typing of staphylococcal cassette chromosome mec types I to V in methicillin-resistant Staphylococcus aureus","volume":"26","author":"Zhang","year":"2012","journal-title":"Mol. Cell. Probes."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.micpath.2016.10.028","article-title":"Staphylococcal chromosomal cassettes mec (SCCmec): A mobile genetic element in methicillin-resistant Staphylococcus aureus","volume":"101","author":"Liu","year":"2016","journal-title":"Microb. Pathog."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1128\/AAC.02302-16","article-title":"Evolutionary Origin of the Staphylococcal Cassette Chromosomemec (SCCmec)","volume":"61","author":"Rolo","year":"2017","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0020191","article-title":"Diversity of SCCmec Elements in Methicillin-Resistant Coagulase-Negative Staphylococci Clinical Isolates","volume":"6","author":"Zong","year":"2011","journal-title":"PLoS ONE"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1128\/AEM.05594-11","article-title":"Methicillin-Resistant Coagulase-Negative Staphylococci on Pig Farms as a Reservoir of Heterogeneous Staphylococcal Cassette Chromosome mec Elements","volume":"78","author":"Tulinski","year":"2012","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.micpath.2017.03.010","article-title":"Current methodologies on genotyping for nosocomial pathogen methicillin-resistant Staphylococcus aureus (MRSA)","volume":"107","author":"Miao","year":"2017","journal-title":"Microb. Pathog."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4172\/2161-0703.1000147","article-title":"Molecular Methods in Epidemiology of Methicillin Resistant Staphylococcus aureus (MRSA): Advantages, Disadvantages of Different Techniques","volume":"3","author":"Szabo","year":"2014","journal-title":"J. Med. Microbiol. Diagn."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S1473-3099(12)70238-4","article-title":"The role of the Panton-Valentine leucocidin toxin in staphylococcal disease: A systematic review and meta-analysis","volume":"13","author":"Shallcross","year":"2013","journal-title":"TheLancet. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fcimb.2017.00101","article-title":"Hospital Dissemination of tst-1-Positive Clonal Complex 5 (CC5) Methicillin-Resistant Staphylococcus aureus","volume":"7","author":"Wang","year":"2017","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fmicb.2015.00348","article-title":"Molecular epidemiology of Methicillin-resistant Staphylococcus aureus in Africa: A systematic review","volume":"6","author":"Abdulgader","year":"2015","journal-title":"Front. Microbiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"206","DOI":"10.3855\/jidc.4620","article-title":"Changing molecular epidemiology of methicillin-resistant Staphylococcus aureus in an algerian hospital","volume":"9","author":"Basset","year":"2015","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.patbio.2013.05.006","article-title":"Staphylococcal cassette chromosome mec characterisation of methicillin-resistant Staphylococcus aureus strains isolated at the military hospital of Constantine\/Algeria","volume":"61","author":"Ouchenane","year":"2013","journal-title":"Pathol.-Biol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.medmal.2011.09.010","article-title":"Emergence of vancomycin-resistant Staphylococcus aureus identified in the Tlemcen university hospital (North-West Algeria)","volume":"41","author":"Rebiahi","year":"2011","journal-title":"M\u00e9decine Mal. Infect."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.medmal.2014.01.006","article-title":"Emergence of the European ST80 clone of community-associated methicillin-resistant Staphylococcus aureus as a cause of healthcare-associated infections in Eastern Algeria","volume":"44","author":"Alioua","year":"2014","journal-title":"M\u00e9decine Mal. Infect."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1128\/AAC.50.3.1083-1085.2006","article-title":"Detection of methicillin-resistant Staphylococcus aureus strains resistant to multiple antibiotics and carrying the Panton-Valentine leukocidin genes in an Algiers hospital","volume":"50","author":"Bes","year":"2006","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1093\/jac\/dkw431","article-title":"MRSA infections among patients in the emergency department: A European multicentre study","volume":"72","author":"Bouchiat","year":"2017","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1017\/ice.2015.323","article-title":"Determinants of Outcome in Hospitalized Patients With Methicillin-Resistant Staphylococcus aureus Bloodstream Infection: Results From National Surveillance in Canada, 2008\u20132012","volume":"37","author":"Simor","year":"2016","journal-title":"Infect. Control. Hosp. Epidemiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1016\/j.patbio.2009.07.017","article-title":"Forte prevalence des infections communautaires et nosocomiales \u00e0Staphylococus aureus r\u00e9sistant \u00e0 la m\u00e9ticilline et portant le g\u00e8ne de la leucocidine de Panton-Valentine dans l\u2019Alg\u00e9rois","volume":"58","author":"Antri","year":"2010","journal-title":"Pathol.-Biol."},{"key":"ref_32","first-page":"49","article-title":"Panton-Valentine leukocidin positive sequence type 80 methicillin-resistant Staphylococcus aureus carrying a staphylococcal cassette chromosome mec type IVc is dominant in neonates and children in an Algiers hospital","volume":"36","author":"Djoudi","year":"2013","journal-title":"New Microbiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"E398","DOI":"10.1111\/1469-0691.12199","article-title":"Molecular epidemiology of Staphylococcus aureus strains isolated from inpatients with infected diabetic foot ulcers in an Algerian University Hospital","volume":"19","author":"Djahmi","year":"2013","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1089\/mdr.2014.0156","article-title":"Descriptive Epidemiology of Nasal Carriage of Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus among Patients Admitted to Two Healthcare Facilities in Algeria","volume":"21","author":"Djoudi","year":"2015","journal-title":"Microbial. Drug Resist."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fmicb.2017.00838","article-title":"Molecular Epidemiology and Antibiotic Resistance Profiles of Methicillin-Resistant Staphylococcus aureus Strains in a Tertiary Hospital in China","volume":"8","author":"Kong","year":"2017","journal-title":"Front. Microbiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1128\/JCM.01890-09","article-title":"Emergence of SCCmec type IV and SCCmec type V methicillin-resistant Staphylococcus aureus containing the Panton-Valentine leukocidin genes in a large academic teaching hospital in Central Switzerland: External invaders or persisting circulators?","volume":"48","author":"Valsesia","year":"2010","journal-title":"J. Clin. Microbiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12879-017-2384-y","article-title":"Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infection and the molecular characteristics of MRSA bacteraemia over a two-year period in a tertiary teaching hospital in Malaysia","volume":"17","author":"Sit","year":"2017","journal-title":"BMC Infect. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1017\/S095026881400065X","article-title":"Dissemination of methicillin-resistant Staphylococcus aureus SCCmec type IV and SCCmec type V epidemic clones in a tertiary hospital: Challenge to infection control","volume":"143","author":"Dhawan","year":"2015","journal-title":"Epidemiol. Infect."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1007\/s10096-013-1972-z","article-title":"Population structure of methicillin-susceptible Staphylococcus aureus (MSSA) in Portugal over a 19-year period (1992\u20132011)","volume":"15","author":"Tavares","year":"2014","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/femsec\/fiv007","article-title":"Characterisation of Staphylococcus aureus strains isolated from faeces of healthy neonates and potential mother-to-infant microbial transmission through breastfeeding","volume":"91","author":"Benito","year":"2015","journal-title":"FEMS Microbiol. Ecol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0017936","article-title":"A field guide to pandemic, epidemic and sporadic clones of methicillin-resistant Staphylococcus aureus","volume":"6","author":"Monecke","year":"2011","journal-title":"PLoS ONE"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.ijantimicag.2009.08.020","article-title":"Evaluation of dalbavancin, tigecycline, minocycline, tetracycline, teicoplanin and vancomycin against community-associated and multidrug-resistant hospital-associated meticillin-resistant Staphylococcus aureus","volume":"35","author":"Huang","year":"2010","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.3389\/fmicb.2018.01436","article-title":"Molecular Typing of ST239-MRSA-III From Diverse Geographic Locations and the Evolution of the SCC Mec III Element During Its Intercontinental Spread","volume":"9","author":"Monecke","year":"2018","journal-title":"Front. Microbiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1126\/science.1182395","article-title":"Evolution of MRSA During Hospital Transmission and Intercontinental Spread","volume":"327","author":"Harris","year":"2010","journal-title":"Science"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Soliman, M.S., Soliman, N.S., El-Manakhly, A.R., ElBanna, S.A., Aziz, R.K., and El-Kholy, A.A. (2020). Genomic Characterisation of Methicillin-Resistant Staphylococcus aureus (MRSA) by High-Throughput Sequencing in a Tertiary Care Hospital. Genes, 11.","DOI":"10.3390\/genes11101219"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"629","DOI":"10.5897\/AJMR2017.8742","article-title":"Study on prevalence and genetic discrimination of methicillin-resistant Staphylococcus aureus (MRSA) in Egyptian hospitals","volume":"12","author":"Elshimy","year":"2018","journal-title":"Afr. J. Microbiol. Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1128\/JCM.03117-13","article-title":"Prediction of Staphylococcus aureus Antimicrobial Resistance By Whole-Genome Sequencing","volume":"52","author":"Gordon","year":"2014","journal-title":"J. Clin. Microbiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1099\/jmm.0.070722-0","article-title":"Characteristics of hospital- and community-acquired meticillin-resistant Staphylococcus aureus in Tehran, Iran","volume":"63","author":"Rahimi","year":"2014","journal-title":"J. Med. Microbiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"211","DOI":"10.2174\/1874285801711010211","article-title":"Antibiotic Resistance Patterns and Virulence Determinants of Different SCCmec and Pulsotypes of Staphylococcus aureus Isolated from a Major Hospital in Ilam, Iran","volume":"11","author":"Abbasi","year":"2017","journal-title":"Open Microbiol. J."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Bendary, M., HEGAZY, W., Sweed, A., Samir, M., Mosbah, R., Ghaith, D., Abdelaziz, A., Ramadan, H., Alshareef, W., and Abd El Hamid, M. (2020). Clonal Diversity and Epidemiological Characteristics of ST239-MRSA Strains. Authorea.","DOI":"10.22541\/au.160097886.69723202"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1128\/CMR.00059-12","article-title":"Antimicrobial Resistance and Virulence: A Successful or Deleterious Association in the Bacterial World?","volume":"26","author":"Beceiro","year":"2013","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_52","first-page":"575","article-title":"Molecular characterisation and susceptibility of methicillin-resistant and methicillin-susceptible Staphylococcus aureus isolates from hospitals and the community in Vladivostok, Russia","volume":"80","author":"Baranovich","year":"2009","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"5848","DOI":"10.1128\/JB.00951-10","article-title":"Complete Genome Sequence of Staphylococcus aureus Strain JKD6008, an ST239 Clone of Methicillin-Resistant Staphylococcus aureus with Intermediate-Level Vancomycin Resistance","volume":"192","author":"Howden","year":"2010","journal-title":"J. Bacteriol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"28","DOI":"10.7883\/yoken.64.28","article-title":"Characterisation of SCCmec Types and Antibacterial Susceptibility Patterns of Methicillin-Resistant Staphylococcus aureus in Southern Iran","volume":"64","author":"Japoni","year":"2011","journal-title":"Jpn. J. Infect. Dis."},{"key":"ref_55","first-page":"1","article-title":"USA300 and USA500 Clonal Lineages of Staphylococcus aureus Do Not Produce a Capsular Polysaccharide Due to Conserved Mutations in the cap5 Locus","volume":"6","author":"Li","year":"2015","journal-title":"MBio"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1038\/nrmicro.2017.27","article-title":"Leukocidins: Staphylococcal bi-component pore-forming toxins find their receptors","volume":"15","author":"Spaan","year":"2017","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/S0140-6736(02)07877-7","article-title":"Association between Staphylococcus aureus strains carrying gene for Panton-Valentine leukocidin and highly lethal necrotising pneumonia in young immunocompetent patients","volume":"359","author":"Gillet","year":"2018","journal-title":"Lancet"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1111\/j.1574-695X.2008.00376.x","article-title":"Serotyping of Dutch Staphylococcus aureus strains from carriage and infection","volume":"52","author":"Melles","year":"2008","journal-title":"FEMS Immunol. Med. Microbiol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1142\/S0192415X11009123","article-title":"Preliminary molecular epidemiology of the Staphylococcus aureus in lower respiratory tract infections: A multicenter study in China","volume":"124","author":"Li","year":"2011","journal-title":"Chin. Med. J."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1007\/s13213-014-0802-6","article-title":"Detection of some phenotypic and genotypic characteristics of Staphylococcus aureus isolated from food items in the Czech Republic","volume":"64","author":"Alibayov","year":"2014","journal-title":"Ann. Microbiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1146\/annurev.immunol.17.1.435","article-title":"The structural basis of t cell activation by superantigens","volume":"17","author":"Li","year":"1999","journal-title":"Annu. Rev. Immunol."},{"key":"ref_62","first-page":"1","article-title":"Staphylococcal Superantigens: Pyrogenic Toxins Induce Toxic Shock","volume":"1","author":"Krakauer","year":"2019","journal-title":"Toxins"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.2217\/fmb.10.127","article-title":"MALDI-TOF-mass spectrometry applications in clinical microbiology","volume":"5","author":"Seng","year":"2010","journal-title":"Future Microbiol."},{"key":"ref_64","unstructured":"Cockerill, F. (2012). Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement, Clinical and Laboratory Standard Institute."},{"key":"ref_65","unstructured":"(2021, October 06). Soci\u00e9te Francaise de Microbiologie Comite de L\u2019antibiogramme de la Societe Francaise de Microbiologie Recommandations. Comit\u00e9 de L\u2019Antibio, Available online: https:\/\/www.sfm-microbiologie.org\/wp-content\/uploads\/2020\/07\/CASFM_2013.pdf."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.diagmicrobio.2004.09.003","article-title":"Cefoxitin disk diffusion screen for confirmation of oxacillin-resistant Staphylococcus aureus isolates and utility in the clinical laboratory","volume":"51","author":"Sharp","year":"2005","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"2766","DOI":"10.1128\/JCM.40.8.2766-2771.2002","article-title":"Evaluation of three techniques for detection of low-level methicillin-resistant Staphylococcus aureus (MRSA): A disk diffusion method with Cefoxitin and Moxalactam, the Vitek 2 system, and the MRSA-screen latex agglutination test","volume":"40","author":"Felten","year":"2002","journal-title":"J. Clin. Microbiol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0149396","article-title":"The emergence and spread of multiple livestock-associated clonal complex 398 methicillin-resistant and methicillin-susceptible Staphylococcus aureus strains among animals and humans in the Republic of Ireland, 2010\u20132014","volume":"11","author":"Brennan","year":"2016","journal-title":"PLoS ONE"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1128\/JCM.38.3.1008-1015.2000","article-title":"Multilocus Sequence Typing for Characterisation of Methicillin-Resistant and Methicillin-Susceptible Clones of Staphylococcus aureus Multilocus Sequence Typing for Characterisation of Methicillin- Resistant and Methicillin-Susceptible Clones of Staphyloco","volume":"38","author":"Enright","year":"2000","journal-title":"J. Clin. Microbiol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1093\/bioinformatics\/btu661","article-title":"A5-miseq: An updated pipeline to assemble microbial genomes from Illumina MiSeq data","volume":"31","author":"Coil","year":"2015","journal-title":"Bioinformatics"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1093\/bioinformatics\/btu153","article-title":"Prokka: Rapid prokaryotic genome annotation","volume":"30","author":"Seemann","year":"2014","journal-title":"Bioinformatics"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/10\/11\/1503\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:31:59Z","timestamp":1760167919000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/10\/11\/1503"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,18]]},"references-count":71,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["pathogens10111503"],"URL":"https:\/\/doi.org\/10.3390\/pathogens10111503","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,18]]}}}