الفهرس 
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Abstract
Staphylococcus aureus is an opportunistic pathogen causing high morbidity and mortality. MRSA isolates that harbor Staphylococcal Cassette chromosome mec (SCCmec) and expresses various types of toxins are the most serious strains. Investigation of SCCmec elements and common toxin genes (TGs) among MRSA isolates recovered from Egyptian hospitals were performed. Out of 200 clinical specimens, S. aureus was detected phenotypically and confirmed as MRSA by PCR in 124 isolates. S. aureus rate was high in wounds, sputum, blood, and urine isolates, and was low in protenial fluids and ear swabs. Antimicrobial resistance rates against cefotaxime, tetracycline, gentamicin, ciprofloxacin, erythromycin, azithromycin, clindamycin, chloramphenicol, sulfamethoxazole- trimethoprim, linezolid and vancomycin were 82.3%, 65.3%, 56.5%, 45.2%, 37.1%, 32.3%, 32.3%, 20.2%, 7.3%, 2.4% and 0%, respectively. Resistance was higher in mid-age group and MDR was detected among 63.7% of isolates. MRSA SCCmec was typed by two methods. M-PCR was able to detect SCCmec element among 57 % of isolates classified as SCCmec II (n=40), III (n=21), IVa (n=3), IVd (n=2), and V (n=1), plus four isolates contain both SCCmec ІІ and SCCmec ІV. Traditional typing by PCR for mec and ccr gene complexes was almost concordant with M-PCR. Furthermore, it was able to identify SCCmec types VI, IX, and XIV among 1, 3 and 18 isolates, respectively. SCCmec XIV elements were detected with SCCmec ІІ (5 isolates) and SCCmec ІІІ (7 isolates). One strain was considered as a novel combination between mecc and ccr2 Some isolates had only ccr (19), mec.