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Waves of resistance: Staphylococcus aureus in the antibiotic era
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Journal Article
Waves of resistance: Staphylococcus aureus in the antibiotic era
2009
Overview
Key Points
Staphylococcus aureus
is notorious for its ability to become resistant to antibiotics. Antibiotic resistance in this organism has occurred in epidemic waves, beginning with the emergence of strains that were resistant to penicillin and progressing to the present pandemic of community-associated methicillin-resistant
S. aureus
(CA-MRSA). This article reviews the recent evolutionary history of drug-resistant strains of
S. aureus
.
We discuss the molecular epidemiology of the epidemics of penicillin- and methicillin-resistant strains of
S. aureus
that have occurred since 1940 and their common features.
The evolution of the mobile chromosome cassette element SCC
mec
, which carries
mecA
, the gene that determines resistance to methicillin and the entire class of β-lactam antibiotics, is also reviewed.
The clinical and molecular epidemiology of CA-MRSA is then discussed, along with the virulence determinants that are present in CA-MRSA strains and the possible genetic basis of the epidemicity and disease severity that is associated with these strains.
Finally, we look at antimicrobial therapy in the era of CA-MRSA.
Epidemics caused by antibiotic-resistant strains of
Staphylococcus aureus
often occur in waves. Here, Henry Chambers and Frank DeLeo review the molecular epidemiology of the epidemic waves of penicillin- and methicillin-resistant strains of
S. aureus
that have occurred since 1940, with a focus on community-associated methicillin-resistant
S. aureus
.
Staphylococcus aureus
is notorious for its ability to become resistant to antibiotics. Infections that are caused by antibiotic-resistant strains often occur in epidemic waves that are initiated by one or a few successful clones. Methicillin-resistant
S. aureus
(MRSA) features prominently in these epidemics. Historically associated with hospitals and other health care settings, MRSA has now emerged as a widespread cause of community infections. Community or community-associated MRSA (CA-MRSA) can spread rapidly among healthy individuals. Outbreaks of CA-MRSA infections have been reported worldwide, and CA-MRSA strains are now epidemic in the United States. Here, we review the molecular epidemiology of the epidemic waves of penicillin- and methicillin-resistant strains of
S. aureus
that have occurred since 1940, with a focus on the clinical and molecular epidemiology of CA-MRSA.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
Anti-Bacterial Agents - pharmacology
/ Biomedical and Life Sciences
/ Community-Acquired Infections - epidemiology
/ Community-Acquired Infections - microbiology
/ Cross Infection - epidemiology
/ Cross Infection - microbiology
/ Drug resistance in microorganisms
/ Humans
/ Staphylococcal Infections - epidemiology
/ Staphylococcal Infections - microbiology
/ Staphylococcus aureus - drug effects
/ Staphylococcus aureus - isolation & purification
/ Staphylococcus aureus infections
/ Virology
