Association of Meca and Lukf-PV Gene Profiles in Clinical Staphylococcus Aureus Isolates with Patient Clinical Outcomes

Abstract

Background: The combined contribution of antimicrobial resistance and virulence determinants to the clinical outcomes of Staphylococcus aureus infection remains poorly understood. This study investigated the association of mecA and lukF-PV gene profiles in clinical Staphylococcus aureus isolates with patient clinical outcomes
Methods: This retrospective observational analytical study included 47 hospitalized adult patients with culture-confirmed Staphylococcus aureus infection at Hasanuddin University Hospital, Indonesia. Clinical and microbiological data from January 2022 to December 2025 were retrospectively retrieved from electronic medical records, while molecular analyses were performed between January and May 2026.
Results: The mecA (+)/lukF-PV (+) gene profile was significantly associated with prolonged hospitalization (OR, 31.17; 95% CI, 4.46–217.60; p = 0.001), prolonged antibiotic therapy (OR, 12.75; 95% CI, 2.33–69.87; p = 0.003), and antimicrobial resistance (OR, 10.21; 95% CI, 1.75–59.65; p = 0.010). The mecA (-)/lukF-PV (+) profile was independently associated with prolonged hospitalization (OR, 9.17; 95% CI, 1.15–73.24; p = 0.037), whereas the mecA (+)/lukF-PV (-) profile was associated only with antimicrobial resistance (OR, 27.50; 95% CI, 2.00–378.84; p = 0.013).
Conclusions: Combined molecular profiling of mecA and lukF-PV identified distinct Staphylococcus aureus strains associated with different clinical outcomes. The mecA (+)/lukF-PV (+) profile showed the strongest association with prolonged hospitalization, prolonged antibiotic therapy, and antimicrobial resistance, suggesting that simultaneous assessment of resistance and virulence determinants may improve risk stratification and complement routine microbiological evaluation in patients with Staphylococcus aureus infection. Prospective multicentre studies with larger sample sizes are warranted to validate these findings