Genetic Diversity of Multidrug-resistant Staphylococcus Aureus in Peri-urban Communities of Southern Nigeria

Antimicrobial resistance (AMR) is a significant public health issue, with its recent reports in Nigeria showing rising resistance among community and clinical bacterial pathogens. Staphylococcus aureus (S. aureus) remains a major issue due to its ability to acquire resistance genes such as mecA and virulence determinants with PVL. However, hospital- based surveillance in Nigeria is increasing, but evidence from peri-urban communities remains limited. Therefore, this study investigated the genetic diversity and antibiotic resistance patterns of multidrug-resistant S. aureus circulating in peri-urban communities of Akwa Ibom State, Southern Nigeria. Nasal and clinical isolates collected from community volunteers between 2019 and 2022 underwent standard culture, susceptibility testing, mecA and pvl PCR screening, and spa typing with phylogenetic analysis. A high proportion of multidrug-resistant isolates, with more than sixty percent resistant to three or more antibiotic classes. Resistance to penicillins, tetracycline, macrolides, and trimethoprim- sulfamethoxazole matched national reports, while susceptibility to vancomycin remained largely preserved. mecA was widely detected, and multiple spa types with clonal complexes were identified, indicating several transmission routes. Phylogenetic clustering suggested local spread between households and primary care settings. There is a need for community-level antimicrobial stewardship, improved surveillance, and integrated One Health strategies to limit further expansion of resistant S. aureus in peri-urban regions of Nigeria.