Abstract
Staphylococcus aureus has been an exceptionally successful pathogen, which is still relevant in modern age-medicine due to its adaptability and tenacity. This bacterium may be a causative agent in a plethora of infections, owing to its abundance (in the environment and in the normal flora) and the variety of virulence factors that it possesses. Methicillin-resistant S. aureus (MRSA) strains—first described in 1961—are characterized by an altered penicillin-binding protein (PBP2a/c) and resistance to all penicillins, cephalosporins, and carbapenems, which makes the β-lactam armamentarium clinically ineffective. The acquisition of additional resistance determinants further complicates their eradication; therefore, MRSA can be considered as the first representative of multidrug-resistant bacteria. Based on 230 references, the aim of this review is to recap the history, the emergence, and clinical features of various MRSA infections (hospital-, community-, and livestock-associated), and to summarize the current advances regarding MRSA screening, typing, and therapeutic options (including lipoglycopeptides, oxazolidinones, anti-MRSA cephalosporins, novel pleuromutilin-, tetracycline- and quinolone-derivatives, daptomycin, fusidic acid, in addition to drug candidates in the development phase), both for an audience of clinical microbiologists and infectious disease specialists.
Highlights
The genus Staphylococcus is included in the Micrococcaceae family within the phylum Actinobacteria [1,2]
Linezolid (Zyvox® [US], Zyvoxid® [EU]; 600 mg/12 h) and tedizolid (Sivextro® [US/EU]; 200 mg/24 h) was approved for the treatment of nosocomial and community-acquired pneumonia, complicated and non-complicated skin, and soft tissue infections and bone and joint infections, while they are not recommended for the treatment of bacteremia and endocarditis
S. aureus is a fine example of a successful pathogen, which was able to morph and adapt with such tenacity to the changing landscape of modern medical interventions and the available antimicrobial agents
Summary
The genus Staphylococcus is included in the Micrococcaceae family within the phylum Actinobacteria [1,2]. They are Gram-positive, catalase-positive, and bacitracin-resistant cocci [3]. Staphylococci are non-spore forming bacteria, they are very common in nature and they can survive in a variety of harsh environments outside of the body, in addition to being resistant to many disinfecting agents [1,2,4,5]. S. aureus (and its methicillin-resistant counterpart) may colonize various mucosal sites of the body: the nostrils (nares), throat, dedicated areas of the skin (including the axilla, groin, and perineum; these skin surfaces are usually moist), and rectum. S. aureus is an exceptionally successful pathogen, which is still relevant and dangerous in modern age-medicine [7]
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