Antimicrobial Resistance Trends and SCCmec Typing among MRSA-Infected Diabetic Foot Cases in the Al-Najaf Community

Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of healthcare-associated infections worldwide, often linked to multidrug resistance and limited treatment options. This cross-sectional study aimed to investigate the molecular characteristics and antimicrobial resistance profiles of MRSA isolates recovered from diabetic foot ulcers in Al-Najaf Governorate, Iraq. A total of 76 S. aureus isolates were collected from patients attending three major hospitals. Identification was conducted using conventional microbiological methods, and methicillin resistance was confirmed phenotypically via cefoxitin disc diffusion and genotypically through PCR amplification of the mecA gene. SCCmec typing was performed using multiplex PCR. The findings revealed that 92.1% of the isolates were MRSA, with SCCmec type III being the most prevalent (45.7%), followed by type I (24.3%), type IV (10%), and type II (7.1%). Mixed SCCmec types were detected in 12.9% of isolates. Resistance was highest against cefoxitin, oxacillin, and penicillin (over 90%), with notable resistance to macrolides, fluoroquinolones, glycopeptides, and tetracyclines. Linezolid and tigecycline remained the most effective agents, showing the lowest resistance rates. A significant correlation was observed between SCCmec type III and multidrug resistance, supporting its association with healthcare associatedMRSA strains. These findings suggest a shift in MRSA epidemiology in Iraq, with diverse and mixed SCCmec types possibly indicating gene transfer and hybrid strains. Ongoing molecular monitoring and prudent antibiotic use are crucial for effective treatment and control.