Genomic diversity and antimicrobial resistance of Staphylococcus aureus in Saudi Arabia: a nationwide study using whole-genome sequencing
Methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) surveillance in regions with mass gatherings presents unique challenges for public health systems. Saudi Arabia, hosting millions of pilgrims annually, provides a distinctive setting for studying how human mobility shapes bacterial populations, yet comprehensive genomic surveillance data from this region remain limited. Here, we present an integrated analysis of <i>S. aureus</i> isolates collected across seven Saudi Arabian regions, combining whole-genome sequencing with extensive antimicrobial susceptibility testing and standardized metadata following findability, accessibility, interoperability and reusability data principles. Our analysis revealed striking differences between pilgrimage and non-pilgrimage cities. Pilgrimage cities showed significantly higher genetic diversity and antimicrobial resistance rates, harbouring numerous international strains, including recognized clones from diverse geographic origins. Reported lineage dynamics are changing, expanding toward community clones. While genomic prediction of antimicrobial resistance showed high accuracy for some antibiotics, particularly beta-lactams, with varying performance for others, it highlights the necessity for phenotypic testing in clinical settings. Our findings demonstrate how mass gatherings drive bacterial population structures and emphasize the importance of integrated surveillance approaches in regions with significant global connectivity and travel.
Authors
- Abdullah Algaissi
- Samer Zakri
- Ahmed Albarrag (ORCID: https://orcid.org/0000-0002-8829-9371)
- Essam J. Alyamani (ORCID: https://orcid.org/0000-0001-9117-0627)
- Abdulaziz A. Huraysi
- Majed F. Alghoribi (ORCID: https://orcid.org/0000-0002-2122-8640)
- Abdulrahman S. Bazaid (ORCID: https://orcid.org/0000-0002-5884-0278)
- Anwar M. Hashem (ORCID: https://orcid.org/0000-0002-8471-7011)
- Rakan Felemban
- Abrar A. Bakr (ORCID: https://orcid.org/0000-0002-8104-1271)
- Sumayh A. Aldakeel (ORCID: https://orcid.org/0000-0003-4750-1163)
- Haya I. Hobani
- Ibrahim Alzahrani (ORCID: https://orcid.org/0000-0003-3879-5833)
- Hind Aldakhil (ORCID: https://orcid.org/0000-0001-9491-103X)
- Musaad A. Altammami (ORCID: https://orcid.org/0000-0003-1869-1527)
- Robert Hoehndorf (ORCID: https://orcid.org/0000-0001-8149-5890)
- Maha Alzayer (ORCID: https://orcid.org/0009-0003-9440-8436)
- Meshari Alazmi (ORCID: https://orcid.org/0000-0001-9074-1029)
- Mai Kaaki
- Basel M. Alnafjan
- Hassan A. Hemeg (ORCID: https://orcid.org/0000-0002-0394-4512)
- Mohammed S. Almogbel (ORCID: https://orcid.org/0000-0002-8733-1472)
- Amani Almaabadi
- Wafaa Alhazmi (ORCID: https://orcid.org/0000-0001-5322-0953)
- Mohammed H. Abutarboush (ORCID: https://orcid.org/0000-0001-9208-5328)
- Wesam Bahitham (ORCID: https://orcid.org/0009-0008-5741-1042)
- Azzam A. Alquait
- Fahad M. Alhoshani (ORCID: https://orcid.org/0000-0002-4258-0432)
- Marwa Abdelhakim (ORCID: https://orcid.org/0000-0001-6816-2119)
- Hanan H. Balkhy (ORCID: https://orcid.org/0000-0002-6968-2834)
- Şenay Kafkas (ORCID: https://orcid.org/0000-0001-7509-5786)
- Abdulrahman A. Alswaji (ORCID: https://orcid.org/0000-0003-1713-9335)
- Reema A. Bawazeer
- Sharif Hala (ORCID: https://orcid.org/0009-0007-1195-014X)
- Abdulaziz Alhazmi
- Séamus Fanning (ORCID: https://orcid.org/0000-0002-1922-8836)
- Maxat Kulmanov (ORCID: https://orcid.org/0000-0003-1710-1820)
- Nader Kameli (ORCID: https://orcid.org/0000-0003-3709-6993)
- Ali M. Somily (ORCID: https://orcid.org/0000-0002-9634-6107)
- Turki S. Abujamel
- Bandar A. Suliman (ORCID: https://orcid.org/0000-0003-0649-3419)
- Essam A. Tawfik (ORCID: https://orcid.org/0000-0003-0716-3251)
- Edrous Alamer (ORCID: https://orcid.org/0000-0002-9700-1610)
- Majid Darraj (ORCID: https://orcid.org/0000-0003-2291-1254)
- Fayez S. Bahwerth (ORCID: https://orcid.org/0000-0001-6618-9422)
- Mohammed A. Alolayan
- Satoru Miyazaki
- Tamir Abdelrahman (ORCID: https://orcid.org/0000-0003-0381-9524)
- Pei‐Ying Hong (ORCID: https://orcid.org/0000-0002-4474-6600)
- Amjad A. Shajri
- Omniya Fallatah
- Mushtaq Ahmad Khan (ORCID: https://orcid.org/0000-0002-2434-1411)
- Sameera Aljohani
- Bassam Alalwan (ORCID: https://orcid.org/0000-0002-4814-579X)
- Takashi Gojobori
- Mohammad Al-Shehri
- Mohammed Alarawi (ORCID: https://orcid.org/0000-0001-8986-8209)
- Badreldin S. Rahama
- Areej G. Aljohani
- Mohammed S. Abdoh (ORCID: https://orcid.org/0009-0004-4281-6953)
- Bandar Kameli
- O. O. Sufyani
- Lamia Alosaimi
- Mohammed B. Al-Fageeh
- Robert Radley (ORCID: https://orcid.org/0009-0000-7112-317X)
- Dalal M. Alkuraithy
Institutions
- University College Dublin (IE)
- Queen's University Belfast (GB)
- King Abdulaziz City for Science and Technology (SA)
- Tokyo University of Science (JP)
- King Abdulaziz University (SA)
- King Saud bin Abdulaziz University for Health Sciences (SA)
- United Arab Emirates University (AE)
- Taibah University (SA)
- King Faisal Specialist Hospital & Research Centre (SA)
- King Saud Medical City (SA)
- King Saud University (SA)
- King Abdulaziz Medical City (SA)
- Saudi Arabian Monetary Authority (SA)
- University of Ha'il (SA)
- King Abdullah International Medical Research Center (SA)
- University of Jeddah (SA)
- World Health Organization (CH)
- King Abdul Aziz University Hospital (SA)
- Ministry of Health (SA)
- King Abdulaziz Hospital (SA)
- Islamic University of Madinah (SA)
- Hera General Hospital (SA)
- King Abdullah Medical City (SA)
- National Guard Health Affairs (SA)
- King Abdullah University of Science and Technology (SA)
- Jazan University (SA)
Publication Details
- Journal
- Microbial Genomics
- Published
- 2025-11-12
- DOI
- https://doi.org/10.1099/mgen.0.001540
- Primary Topic
- Antimicrobial Resistance in Staphylococcus
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- King Abdullah University of Science and Technology
- King Abdulaziz City for Science and Technology