Vancomycin Resistance among Methicillin-Resistant Staphylococcus aureus Isolated from Clinical Samples in Sana’a City,Yemen
Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a critical global public health concern. The emergence of Vancomycin-Resistant S. aureus (VRSA) poses a severe therapeutic challenge. This crosssectional study was conducted to determine the prevalence of VRSA and to assess antibiotic resistance patterns in major hospitals in Sana’a City, Yemen.
Objectives: This study aimed to determine the prevalence of vancomycin-resistant MRSA (VR-MRSA) isolates collected from clinical samples in Sana’a city, Yemen.
Methods: A cross-sectional study was conducted between June 2025 and August 2025. A total of 250 confirmed MRSA clinical isolates (including pus, urine, sputum, blood, vaginal swabs, ear swabs, nasal swabs, and body fluids) were analyzed in this study. Standard phenotypic methods were used to identify S. aureus, and MRSA was detected using cefoxitin disk diffusion. VRSA isolates were confirmed using the Epsilometer test (E-test) method. Antimicrobial susceptibility testing was performed using the Kirby Bauer disk diffusion method. Data analysis was performed using SPSS version 26, with statistical significance (p < 0.05).
Results: Among the 250 MRSA isolates, eight (3.2%) were confirmed to be VRSA. The highest proportion of MRSA isolates was from pus (58.6%), with a higher VRSA rate among males (62.5%). Significant statistical associations (p < 0.05) were found between VRSA and the use of invasive medical devices, central lines, and surgery. Resistance to several antibiotics, including rifampin, teicoplanin, and trimethoprim/sulfamethoxazole, was statistically significant (p < 0.05).
Conclusion: This study confirmed the low prevalence of VRSA but documented its local emergence among clinical isolates, highlighting a critical public health threat. While significant resistance was observed to multiple common antimicrobials, linezolid showed superior efficacy. The frequent recovery of resistant strains from pus samples and their strong association with patients with underlying chronic diseases (notably diabetes and hypertension) underscore the need for targeted antimicrobial stewardship and robust infection control programs guided by continuous surveillance data.
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