Epidemiology and Mechanisms of Methicillin-Resistant Staphylococcus aureus
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a leading cause of hospital- and community-acquired infections worldwide. Originally confined to healthcare settings, MRSA lineages have diversified into community-associated and livestock-associated strains, reflecting a One Health paradigm in which human, animal and environmental reservoirs intersect. The principal molecular mechanism of resistance is acquisition of the mecA gene within a mobile staphylococcal cassette chromosome mec (SCCmec), encoding the penicillin-binding protein PBP2a with low affinity for β-lactam antibiotics. Horizontal transfer of SCCmec among Staphylococcus aureus populations, coupled with clonal expansion of successful lineages, underpins global dissemination. Concurrently, a versatile repertoire of virulence factors — including surface adhesins, extracellular toxins and biofilm-forming operons — enhances colonisation, invasion and immune evasion. Epidemiological surveillance has revealed marked regional variation in dominant clones: for example, ST239 in certain Asian hospitals, ST45 emerging in bloodstream infections, and USA300 predominating in North American communities. Risk factors for colonisation and disease include prior antibiotic exposure, residence in long-term care facilities, indwelling devices and comorbidities such as diabetes. The escalating prevalence of multidrug-resistant MRSA variants, some demonstrating reduced susceptibility to last-line agents such as vancomycin, underscores the imperative for integrated strategies encompassing molecular surveillance, antimicrobial stewardship, infection control and novel therapeutic development.
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Epidemiology and Mechanisms of Methicillin-Resistant Staphylococcus aureus publication trend
The graph below shows the total number of articles in epidemiology and mechanisms of methicillin-resistant staphylococcus aureus across all publications each year (not limited to Nature Index journals).
Technical terms
SCCmec: Staphylococcal chromosomal cassette carrying mec genes that confer methicillin resistance.
mecA gene: Gene encoding PBP2a, a β-lactam-resistant penicillin-binding protein.
PBP2a: Altered penicillin-binding protein with low affinity for β-lactam antibiotics, mediating methicillin resistance.
Clonal complex (CC): Group of related MRSA strains defined by shared multilocus sequence types.
Panton-Valentine leukocidin (PVL): Cytotoxin associated with tissue necrosis and severe skin infections.
References
- Phylogenetic Analysis and Virulence Characteristics of Methicillin-Resistant Staphylococcus aureus ST45 in China: a Hyper-Virulent Clone Associated with Bloodstream Infections. mSystems (2023).
- MRSA compendium of epidemiology, transmission, pathophysiology, treatment, and prevention within one health framework. Frontiers in Microbiology (2023).
- The global prevalence of methicillin-resistant Staphylococcus aureus colonization in residents of elderly care centers: a systematic review and meta-analysis. Antimicrobial Resistance & Infection Control (2023).
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