Mechanisms of antimicrobial resistance of Staphylococcus aureus strains: narrative synthesis

Abstract

One of the causes of the increasing incidence in recent years, worldwide, of bacterial infections resulting in therapeutic failure is the unjustified use of antimicrobials and the dissemination of antibiotic resistance factors. Currently, infections, caused by Staphylococcus aureus appear to be caused by a pathogen multiresistant to a very wide range of antimicrobials used in medical practice. A narrative synthesis study was conducted. The analysis of publications between 2012-2022 was carried out regarding the theoretical aspects of the antimicrobial resistance mechanisms characteristic of Staphylococcus aureus strains, by using the terms "Resistance mechanisms", "Resistance genes", "Staphylococcus aureus", "Antimicrobial preparations". The initial search yielded 44 articles, from which 27 eligible papers were selected and analyzed. S. aureus is one of the most important pathogens in terms of antimicrobial resistance, as it has been able to develop resistance mechanisms to almost all preparations used against it. This species can easily exemplify adaptive evolution to antimicrobials, as it has demonstrated a unique ability to rapidly respond to each new antibiotic by developing a resistance mechanism, starting with penicillin and methicillin, and ending with the newer ones, linezolid and daptomycin. The main mechanisms of S. aureus resistance to antimicrobials are enzymatic inactivation of the antibiotic, modification of the attack target, antibiotic uptake and efflux pumps. Antimicrobial resistance mechanisms are very diverse and can be intrinsic or acquired, therefore understanding them can create new treatment alternatives for infectious pathology and facilitate the development of new antimicrobials that will counteract the attempts of microorganisms to become resistant.