Hidden reservoirs in clinical settings: Clonal dissemination and virulence profile of multidrug-resistant Staphylococcus aureus from healthcare workers' mobile phones.

Authors

Mehdi Goudarzi, Mohammad Javad Nasiri, Masoud Dadashi, Hossein Goudarzi

Published in

Acta microbiologica et immunologica Hungarica. Aug 17, 2026. Epub Aug 17, 2026.

Abstract

Mobile phones used in healthcare environments may serve as overlooked reservoirs facilitating the transmission of clinically significant pathogens. This study investigated antimicrobial resistance patterns, virulence-associated determinants, and genetic diversity among Staphylococcus aureus isolates recovered from healthcare workers' mobile phones. Phenotypic antimicrobial susceptibility testing, staphylococcal cassette chromosome mec (SCCmec) typing, multilocus sequence typing (MLST), and polymerase chain reaction assays were employed to detect antimicrobial resistance, biofilm-associated, and toxin-encoding genes. Among 349 mobile phones screened, 42 (12%) were positive for S. aureus. Among the isolates, 76.2% were identified as methicillin-resistant S. aureus (MRSA), while 23.8% were methicillin-susceptible S. aureus (MSSA). High-level mupirocin resistance (HLMUPR) and inducible macrolide-lincosamide-streptogramin B (iMLSB) phenotypes were observed in 26.2 and 35.7% of isolates, respectively. Biofilm formation analysis demonstrated that 49.2% of isolates were strong biofilm producers, followed by intermediate (30.8%) and weak producers (15.4%). Of the 42 isolates examined, 12 (28.6%) harbored the pvl gene, and 10 (23.8%) harbored the tst gene. The most frequently detected resistance gene was erm(B) (33.3%), followed by msrA (19%) and erm(C) (16.7%). All isolates harbored the adhesion genes fnbA and fnbB. Additional biofilm- and adhesion-associated genes included clfA and clfB (85.7%), cna and fib (38.1%), icaA (35.7%), icaD (33.3%), sdrD (28.6%), sdrC, sdrE, eno, and bap (21.4% each), while ebpS was detected in 4.8% of isolates. MLST analysis revealed distribution across six clonal complexes, predominantly CC8 (42.9%), followed by CC5 (21.4%), CC59 (11.9%), CC22 (11.9%), CC1 (7.1%), and CC398 (4.8%). Panton-Valentine leukocidin (PVL)-positive isolates were mainly associated with ST8-SCCmec IV/t008 and ST22/t1869 lineages, whereas toxic shock syndrome toxin (TSST-1)-positive strains belonged primarily to ST239-SCCmec III/t037 and ST59-SCCmec IV/t437. High-level mupirocin-resistant isolates carrying mupA were distributed among several epidemic clones, including ST5-SCCmec IV/t002 (36.4%), ST8-SCCmec IV/t008 (27.2%), ST239-SCCmec III/t037 (18.2%), and ST22/t1869 (18.2%). Overall, the findings demonstrate substantial circulation of multidrug-resistant and virulence-associated S. aureus lineages on healthcare workers' mobile phones, underscoring their potential role in pathogen dissemination and emphasizing the necessity for targeted infection prevention and mobile device decontamination strategies in healthcare settings.

PMID:
42606904
Bibliographic data and abstract were imported from PubMed on 18 Aug 2026.

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