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oai:figshare.com:article/33809737 2026-09-15T17:25:52Z category_7 category_8 category_21 category_272 category_39 category_734 category_811 category_64 category_106 category_132 portal_5 item_type_3 month_year_09_2026

<p>Annual distribution of MRSA and MSSA, 2013–2024.</p> Abdulah J. Alqahtani (21955367) Yahya Shabi (23091619) Ghaday Hadi (24609547) Abdullah Algarni (14485472) Anandhalakshmi Subramanian (24947890) Ihab M. Abdelrahim (24677173) Ali Al bshabshe (17807467) Tarik Alazraqi (24609550) Safia Abdullah Mohammed (24677161) Sara Habbash (24609553) Mona M. Alfaki (24947893) Abdulah O. S. Bawazeer (24422447) Medicine Microbiology Biotechnology Environmental Sciences not elsewhere classified Ecology Biological Sciences not elsewhere classified Mathematical Sciences not elsewhere classified Cancer Science Policy Infectious Diseases yet longitudinal data trimethoprim &# 8211 multivariable model accounting identified independent predictors 06 &# 8211 daptomycin retained full based surveillance study priority resistance threat level linezolid non estimated annual non staphylococcus aureus </ susceptibility also increased 7 &# 8211 2013 – 2024 mrsa share rose susceptibility trends among 0 %); fusidic center aseer surveillance 2 %; 95 231 mrsa isolates based surveillance 963 mssa isolates aureus </ daptomycin non care center 2024 ), 231 isolates temporal trends widest gap vs 25 vitro activity teicoplanin non tailored empirical susceptibility trends stewardship guidance saudi arabia retrospective laboratory leading cause lactam resistance independently associated fusidic acid <div> <p>Background</p><p><i>Staphylococcus aureus</i> is a leading cause of infection, and methicillin-resistant <i>S. aureus</i> (MRSA) is a high-priority resistance threat. MRSA and methicillin-susceptible <i>S. aureus</i> (MSSA) differ in non-β-lactam resistance, yet longitudinal data from Aseer, Saudi Arabia are limited. We characterized methicillin-resistance and non-susceptibility trends to inform local stewardship.</p> <p>Methods</p><p>We conducted a retrospective laboratory-based surveillance study of 4,194 <i>S. aureus</i> isolates from 3,122 patients (aged ≥12 years) at a tertiary-care center in Aseer, Saudi Arabia (January 2013–June 2024). Isolates were classified as MRSA or MSSA by oxacillin/cefoxitin testing to CLSI standards. We estimated annual non-susceptibility proportions and their temporal trends, compared non-susceptibility between MRSA and MSSA, and identified independent predictors of MRSA in a multivariable model accounting for repeated isolates from the same patient.</p> <p>Results</p><p>MRSA accounted for 2,231 isolates (53.2%; 95% CI 51.7–54.7) and MSSA for 1,963 (46.8%); most isolates were from inpatients, including 1,975/2,231 MRSA isolates (88.5%) and 1,648/1,963 MSSA isolates (84.0%). The MRSA share rose from 47.4% (2013) to 60.4% (2024), each later year being independently associated with MRSA (adjusted OR 1.09/year, 95% CI 1.06–1.12). MRSA was significantly more non-susceptible than MSSA to penicillin, ciprofloxacin, levofloxacin, erythromycin, clindamycin, gentamicin, trimethoprim–sulfamethoxazole, tetracycline, fusidic acid and rifampin (all FDR-adjusted p < 0.05), with the widest gap for fusidic acid (62.7% vs 25.0%); fusidic-acid and fluoroquinolone non-susceptibility also increased over time. No vancomycin or daptomycin non-susceptibility was detected; teicoplanin non-susceptibility was low but significantly higher in MRSA (2.8% vs 1.5%), and low-level linezolid non-susceptibility (1.5% vs 1.3%) was not confirmatory-tested.</p> <p>Conclusions</p><p>In this single-center Aseer surveillance, MRSA became the majority of <i>S. aureus</i> during 2013–2024 and showed broad multidrug non-susceptibility, while vancomycin and daptomycin retained full in vitro activity. These local findings support sustained laboratory-based surveillance, Aseer-tailored empirical and stewardship guidance, and confirmatory testing of the emerging low-level linezolid non-susceptibility signal.</p></div> 2026-09-15T17:25:44Z Dataset Dataset 10.1371/journal.pone.0357789.t002 https://figshare.com/articles/dataset/_p_Annual_distribution_of_MRSA_and_MSSA_2013_2024_p_/33809737 CC BY 4.0