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Background <p>Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) poses a significant global public health threat. However, data on community-associated S. aureus (CA-SA) infections in children in Hainan remain scarce. This study aimed to characterize the molecular characteristics of CA-SA isolates obtained from pediatric patients at a university hospital in Hainan, the southernmost province of China.</p> Methods <p>A total of 117 CA-SA isolates, including 31 MRSA and 86 methicillin-susceptible S. aureus (MSSA), were collected in Hainan between July 2023 and May 2025. These isolates were characterized using multilocus sequence typing (MLST), staphylococcal protein A (spa) typing, staphylococcal cassette chromosome mec (SCCmec) typing, and analyses of antimicrobial resistance and virulence gene profiles.</p> Results <p>Eighteen distinct sequence types (STs) and 49 spa types were identified among the 117 isolates, with ST398-t011(15,12.8%) and ST22-t039(15,12.8%) being the most prevalent. ST398 and ST22 were the dominant clones among MSSA isolates, whereas ST59-SCCmec IV/V(10, 8.5%) and ST45-SCCmec IV(9,7.7%) were the predominant clones among MRSA isolates. The prevalence of CA-MRSA was 26.5%, with SCCmec types IV and V accounting for 71% and 29% of cases, respectively. All isolates exhibited susceptibility to tigecycline, teicoplanin, linezolid, and vancomycin, while 69 isolates (59.0%) were classified as multidrug-resistant (MDR). Compared to CA-MSSA strains, CA-MRSA isolates demonstrated significantly higher resistance rates to cefoxitin, oxacillin, erythromycin, clindamycin, and levofloxacin. The predominant resistance genes for erythromycin and tetracycline were ermC (77.2%, 51/66) and tetK (82.4%, 28/34), respectively. Among the 32 virulence genes tested, hla, hld, icaA, and clfA were detected in all isolates, whereas lukM was absent in all. The seb, sel, sek, and seq genes were more frequently identified in CA-MRSA isolates, while sdrD and lukE were more commonly detected in CA-MSSA isolates.</p> Conclusions <p>This study represents the first report on the molecular characteristics of CA-SA strains isolated from pediatric populations in Hainan, identifying ST398, ST22, ST59, and ST45 as the predominant genotypes. Notably, CA-MRSA epidemic strains in this region exhibit substantial molecular heterogeneity, reflecting distinct regional epidemiological patterns. These findings provide updated insights into the molecular epidemiology of S. aureus strains, offering critical reference data for clinical management and infection prevention strategies in pediatric settings.</p>

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Insight into the molecular characteristics of community-associated Staphylococcus aureus isolates from pediatric patients in South China

  • 期刊论文

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  • 发表日期：

    2026年7月9日

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  • Huamiao Tang,
  • Cong Li,
  • Yun Zhou,
  • Xiangmin Zhou,
  • Keni Jian,
  • Xing Wang

摘要

Background

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) poses a significant global public health threat. However, data on community-associated S. aureus (CA-SA) infections in children in Hainan remain scarce. This study aimed to characterize the molecular characteristics of CA-SA isolates obtained from pediatric patients at a university hospital in Hainan, the southernmost province of China.

Methods

A total of 117 CA-SA isolates, including 31 MRSA and 86 methicillin-susceptible S. aureus (MSSA), were collected in Hainan between July 2023 and May 2025. These isolates were characterized using multilocus sequence typing (MLST), staphylococcal protein A (spa) typing, staphylococcal cassette chromosome mec (SCCmec) typing, and analyses of antimicrobial resistance and virulence gene profiles.

Results

Eighteen distinct sequence types (STs) and 49 spa types were identified among the 117 isolates, with ST398-t011(15,12.8%) and ST22-t039(15,12.8%) being the most prevalent. ST398 and ST22 were the dominant clones among MSSA isolates, whereas ST59-SCCmec IV/V(10, 8.5%) and ST45-SCCmec IV(9,7.7%) were the predominant clones among MRSA isolates. The prevalence of CA-MRSA was 26.5%, with SCCmec types IV and V accounting for 71% and 29% of cases, respectively. All isolates exhibited susceptibility to tigecycline, teicoplanin, linezolid, and vancomycin, while 69 isolates (59.0%) were classified as multidrug-resistant (MDR). Compared to CA-MSSA strains, CA-MRSA isolates demonstrated significantly higher resistance rates to cefoxitin, oxacillin, erythromycin, clindamycin, and levofloxacin. The predominant resistance genes for erythromycin and tetracycline were ermC (77.2%, 51/66) and tetK (82.4%, 28/34), respectively. Among the 32 virulence genes tested, hla, hld, icaA, and clfA were detected in all isolates, whereas lukM was absent in all. The seb, sel, sek, and seq genes were more frequently identified in CA-MRSA isolates, while sdrD and lukE were more commonly detected in CA-MSSA isolates.

Conclusions

This study represents the first report on the molecular characteristics of CA-SA strains isolated from pediatric populations in Hainan, identifying ST398, ST22, ST59, and ST45 as the predominant genotypes. Notably, CA-MRSA epidemic strains in this region exhibit substantial molecular heterogeneity, reflecting distinct regional epidemiological patterns. These findings provide updated insights into the molecular epidemiology of S. aureus strains, offering critical reference data for clinical management and infection prevention strategies in pediatric settings.