Abstract
Staphylococcus aureus is an opportunistic pathogen responsible for a wide range of infections in humans, such as skin and soft tissue infections, pneumonia, food poisoning or sepsis. Historically, S. aureus was able to rapidly adapt to anti-staphylococcal antibiotics and become resistant to several classes of antibiotics. Today, methicillin-resistant S. aureus (MRSA) is a multidrug-resistant pathogen and is one of the most common bacteria responsible for hospital-acquired infections and outbreaks, in community settings as well. The rapid and accurate diagnosis of antimicrobial resistance in S. aureus is crucial to the early initiation of directed antibiotic therapy and to improve clinical outcomes for patients. In this narrative review, I provide an overview of recent phenotypic and molecular diagnostic methods for antimicrobial resistance detection in S. aureus, with a particular focus on MRSA detection. I consider methods for resistance detection in both clinical samples and isolated S. aureus cultures, along with a brief discussion of the advantages and the challenges of implementing such methods in routine diagnostics.
Highlights
Staphylococcus aureus is a Gram-positive cocci-shaped bacterium that grows in the characteristic clusters of grapes
Several other molecular biosensors have been described, all targeting the mecA gene: a nanoelectrokinetic sensor [138], a capacitive biosensor tested on a saliva sample [139], a portable and smartphone-controlled colorimetric Loop-Mediated Isothermal Amplification (LAMP) device [140], a hairpin probemediated DNA circuit based on exonuclease III and DNAzyme tested on mecA-spiked serum samples [141], a colorimetric paper-based analytical device [142], a ligation chain reaction electrochemical sensor tested on joint fluid samples [143] and a microfluidic biochip based on roll-to-roll UV nanoimprint technology tested on nasal, throat and inguinal samples [144]
methicillin-resistant S. aureus (MRSA) impact on morbidity and mortality still remain high, especially in hospital settings [148,149,150,151]; the rapid and accurate diagnosis of MRSA makes sure that patients receive the proper antibiotics and improves patient outcomes [16,111]
Summary
Staphylococcus aureus is a Gram-positive cocci-shaped bacterium that grows in the characteristic clusters of grapes. The vast majority of S. aureus isolates are resistant to penicillin [1] To counteract this resistance, new semisynthetic beta-lactams antibiotics were developed (e.g., methicillin, oxacillin). The rapid and accurate detection of S. aureus and its drug resistance (ideally, shortly after or on the same day the patient sample is collected) is of clinical importance for the rapid de-escalation of therapy from broad-spectrum to targeted antibiotics [17]. In this narrative review, I provide an overview of recent phenotypic and molecular diagnostic methods for antimicrobial resistance detection in S. aureus. I hope this narrative review can help clinicians and microbiologists in choosing the proper diagnostic test and in interpreting the relative results
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