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Integrative analysis of Panton-Valentine leucocidin gene, clinical parameters, and miRNAs as predictive biomarkers for sepsis risk in methicillin-resistant Staphylococcus aureus infections | ||
| Journal of University of Anbar for Pure Science | ||
| Volume 20, Issue 2, August 2026, Pages 43-54 PDF (1003.58 K) | ||
| Document Type: Research Paper | ||
| DOI: 10.37652/juaps.2025.163933.1610 | ||
| Authors | ||
| Baidaa Falah Ismail* 1; Essam Mohammed Abdullah2; Warqaa Yassein Khudhur3 | ||
| 1University of Anbar, College of Medicine, Microbiology Department, Ramadi, Iraq | ||
| 2Department of Clinical Laboratory Sciences, College of Pharmacy, University of Anbar, Ramadi, Iraq. | ||
| 3Department of Pediatrics, College of Medicine, University of Anbar, Ramadi, Iraq. | ||
| Abstract | ||
| Methicillin-resistant Staphylococcus aureus (MRSA) infections represent a serious and persistent challenge in contemporary healthcare settings, contributing substantially to morbidity and mortality worldwide. The Panton-Valentine Leukocidin (PVL) gene has been associated with increased virulence and severe clinical manifestations. Recent evidence suggests that host microRNAs (miRNAs), particularly miR-223 and miR-155-5p, may serve as crucial biomarkers for risk stratification in sepsis. This study aimed to investigate the association between PVL gene presence, clinical severity parameters, antibiotic resistance patterns, and the expression of miR-223 and miR-155-5p as predictive biomarkers for sepsis risk in MRSA infections. A prospective case-control study was conducted involving 103 participants (50 MRSA-infected patients, 50 healthy controls, and 3 were excluded). PVL gene detection was performed using PCR, and antibiotic susceptibility testing was conducted according to CLSI guidelines. Clinical parameters were also collected. Statistical analyses included chi-square tests, logistic regression, and ROC curve analysis. Among MRSA cases, 50% (25/50) were PVL-positive, with 56% (28/50) developing sepsis. PVL-positive strains showed significantly higher rates of sepsis (72% vs 40%, p=0.022) and severe sepsis (68% vs 32%, p=0.011). Multivariate analysis revealed PVL positivity (OR=3.89, 95% CI: 1.42-10.65), elevated CRP (OR=1.18, 95% CI: 1.09-1.28), and reduced platelet count (OR=0.992, 95% CI: 0.987-0.997) as independent predictors of sepsis development. Conceptual integration of miR-223 and miR-155-5p expression patterns suggests enhanced predictive accuracy for sepsis risk stratification. The presence of the PVL gene in MRSA isolates significantly correlates with sepsis development and severity. Integration of PVL status with clinical parameters and miRNA biomarkers provides a comprehensive approach for sepsis risk assessment in MRSA infections. | ||
| Keywords | ||
| Methicillin-Resistant Staphylococcus aureus; Panton-Valentine Leukocidin; Sepsis; MicroRNA; Antibiotic Resistance | ||
| References | ||
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