Why staphylococcus aureus is resistant to antibiotics

Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk. Baggett, H. Community-onset methicillin-resistant Staphylococcus aureus associated with antibiotic use and the cytotoxin Panton-Valentine leukocidin during a furunculosis outbreak in rural Alaska. Community-associated methicillin-resistant Staphylococcus aureus infections in Pacific Islanders — Hawaii, — Aiello, A.

Meticillin-resistant Staphylococcus aureus among US prisoners and military personnel: review and recommendations for future studies. Lancet Infect. Diep, B. Emergence of multidrug-resistant, community-associated, methicillin-resistant Staphylococcus aureus clone USA in men who have sex with men. Johansson, P. High prevalence of MRSA in household contacts. Adcock, P. Methicillin-resistant Staphylococcus aureus in two child care centers.

Liu, C. A population-based study of the incidence and molecular epidemiology of methicillin-resistant Staphylococcus aureus disease in San Francisco, — Seybold, U. Emergence of community-associated methicillin-resistant Staphylococcus aureus USA genotype as a major cause of health care-associated blood stream infections. Gilbert, M. Outbreak in Alberta of community-acquired USA methicillin-resistant Staphylococcus aureus in people with a history of drug use, homelessness or incarceration.

Mulvey, M. Community-associated methicillin-resistant Staphylococcus aureus , Canada. Stemper, M. Emergence and spread of community-associated methicillin-resistant Staphylococcus aureus in rural Wisconsin, to David, M. Molecular epidemiology of methicillin-resistant Staphylococcus aureus , rural southwestern Alaska. Pan, E. Increasing prevalence of methicillin-resistant Staphylococcus aureus infection in California jails.

The first description of USA Pannaraj, P. Infective pyomyositis and myositis in children in the era of community-acquired, methicillin-resistant Staphylococcus aureus infection. Widespread skin and soft-tissue infections due to two methicillin-resistant Staphylococcus aureus strains harboring the genes for Panton-Valentine leucocidin. Chavez-Bueno, S. Inducible clindamycin resistance and molecular epidemiologic trends of pediatric community-acquired methicillin-resistant Staphylococcus aureus in Dallas, Texas.

Multilocus sequence typing for characterization of methicillin-resistant and methicillin-susceptible clones of Staphylococcus aureus. Feil, E. Turner, K. BMC Microbiol.

Shopsin, B. Evaluation of protein A gene polymorphic region DNA sequencing for typing of Staphylococcus aureus strains. How clonal is Staphylococcus aureus?

Tenover, F. Characterization of Staphylococcus aureus isolates from nasal cultures collected from individuals in the United States in to Goering, R. Molecular epidemiology of methicillin-resistant and methicillin-susceptible Staphylococcus aureus isolates from global clinical trials.

Hallin, M. Genetic relatedness between methicillin-susceptible and methicillin-resistant Staphylococcus aureus : results of a national survey. Feng, Y. Evolution and pathogenesis of Staphylococcus aureus : lessons learned from genotyping and comparative genomics. FEMS Microbiol. Analyses of clonality and the evolution of bacterial pathogens. Lindsay, J. Microarrays reveal that each of the ten dominant lineages of Staphylococcus aureus has a unique combination of surface-associated and regulatory genes.

Nubel, U. Frequent emergence and limited geographic dispersal of methicillin-resistant Staphylococcus aureus. USA , — Gomes, A.

Origins and evolution of methicillin-resistant Staphylococcus aureus clonal lineages. Analysis of penicillin-susceptible and penicillin-resistant genotypes of S. Re-emergence of early pandemic Staphylococcus aureus as a community-acquired meticillin-resistant clone. Cox, R. Johnson, A. McDougal, L. Pulsed-field gel electrophoresis typing of oxacillin-resistant Staphylococcus aureus isolates from the United States: establishing a national database.

Ito, T. Structural comparison of three types of staphylococcal cassette chromosome mec integrated in the chromosome in methicillin-resistant Staphylococcus aureus. Ma, X. Novel type of staphylococcal cassette chromosome mec identified in community-acquired methicillin-resistant Staphylococcus aureus strains. Oliveira, D. Higuchi, W. Structure and specific detection of staphylococcal cassette chromosome mec type VII. Zhang, K.

Novel staphylococcal cassette chromosome mec type, tentatively designated type VIII, harboring class A mec and type ccr gene complexes in a Canadian epidemic strain of methicillin-resistant Staphylococcus aureus. Ruppe, E. Diversity of staphylococcal cassette chromosome mec structures in methicillin-resistant Staphylococcus epidermidis and Staphylococcus haemolyticus strains among outpatients from four countries.

Okuma, K. Dissemination of new methicillin-resistant Staphylococcus aureus clones in the community. Staphylococcal chromosome cassette evolution in Staphylococcus aureus inferred from ccr gene complex sequence typing analysis.

Sequence typing of SCC mec allotypes to define possible origins and evolution. The evolution of pandemic clones of methicillin-resistant Staphylococcus aureus : identification of two ancestral genetic backgrounds and the associated mec elements. Hanssen, A. Local variants of staphylococcal cassette chromosome mec in sporadic methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative staphylococci: evidence of horizontal gene transfer?

SCC mec in staphylococci: genes on the move. FEMS Immunol. Wu, S. Tracking the evolutionary origin of the methicillin resistance gene: cloning and sequencing of a homologue of mecA from a methicillin susceptible strain of Staphylococcus sciuri. The arginine catabolic mobile element and staphylococcal chromosomal cassette mec linkage: convergence of virulence and resistance in the USA clone of methicillin-resistant Staphylococcus aureus.

Kennedy, A. Epidemic community-associated methicillin-resistant Staphylococcus aureus : recent clonal expansion and diversification. Deep sequence analysis of closely related USA strains and a comparison of their virulence in a mouse model. Bartels, M. Rapid increase of genetically diverse methicillin-resistant Staphylococcus aureus , Copenhagen, Denmark. Gottlieb, T. Recognition of USA isolates of community-acquired methicillin-resistant Staphylococcus aureus in Australia.

Arias, C. Maree, C. Community-associated methicillin-resistant Staphylococcus aureus isolates causing healthcare-associated infections. Community-associated strains of methicillin-resistant Staphylococcus aureus as the cause of healthcare-associated infection.

Tristan, A. Global distribution of Panton-Valentine leukocidin positive methicillin-resistant Staphylococcus aureus , Emergence and characterization of community-associated methicillin-resistant Staphyloccocus aureus infections in Denmark, to Rollason, J. Epidemiology of community-acquired meticillin-resistant Staphylococcus aureus obtained from the UK West Midlands region.

Holmes, A. Staphylococcus aureus isolates carrying Panton-Valentine leucocidin genes in England and Wales: frequency, characterization, and association with clinical disease.

Huijsdens, X. Community-acquired MRSA and pig-farming. Loeffler, A. Crum, N. Fifteen-year study of the changing epidemiology of methicillin-resistant Staphylococcus aureus. Davis, S. Epidemiology and outcomes of community-associated methicillin-resistant Staphylococcus aureus infection.

Complete genome sequence of USA, an epidemic clone of community-acquired meticillin-resistant Staphylococcus aureus. Voyich, J. A total of 1, S. According to the results of susceptibility tests of all isolates of S. While the resistance rates to nitrofurantoin, quinupristin-dalfopristin, and trimethoprim-sulfamethoxazole were determined as 0. Currently, retrospective evaluations of causes of nosocomial infection should be done periodically.

We think that any alteration of resistance over the years has to be identified, and all centers must determine their own resistance profiles, in order to guide empirical therapies. Reducing the rate of antibiotic resistance will contribute to reducing the cost of treatment. Staphylococcus aureus , involved in the Micrococcaceae family, is a Gram-positive, catalase, and coagulase-positive bacteria. Staphylococcus spp.

In spite of being asporous, it is among the bacteria that are most resistant to the external environment and disinfectant agents. These resistant isolates can cause various clinical situations varying between superficial infections and serious life-threatening infections.

Therefore, S. Hospital-acquired methicillin-resistant S. MRSA can easily be spread from patient to patient through the hands of the staff and can lead to frequent epidemics [ 4 , 5 ]. MRSA colonization is common in hospitals. Hand hygiene and isolation measures can be preventive for MRSA. These measures have been shown to reduce hospital-acquired MRSA infections. However, effort has been expended for a long time toward preventing hospital-acquired MRSA infections, and effective infection control measures have been put into practice [ 7 , 8 ].

This study aims to retrospectively determine the resistance rates of S. The antibiotic resistance rates of S. Culture samples were taken from the abscess and the wounds using needle aspiration and swab technique. Isolates produced on sheep blood agar at the end of this period were defined by colony morphology, Gram stain, catalase test, and coagulation test. These systems use microdilution method for antibiotic susceptibility tests.

The interpretations of antibiotic resistance for all years were based on CLSI criteria [ 9 ]. Specific antibiotics were tested in all isolates according to the CLSI guidelines. Statistically, -test and rate comparison were made to determine the resistance rates against methicillin and other antibiotics according to year.

During the study, a total of 1, S. Of these isolates, The distribution of isolated strains according to the clinic and the type of sample is given in Tables 1 and 2.

According to the susceptibility test results done for all years, all S. Resistance rates against nitrofurantoin, quinupristin-dalfopristin, and trimethoprim-sulfamethoxazole were determined as 0. The methicillin resistance rate of S. Methicillin resistance was highest in and decreased in subsequent years. High rate of MRSA in was determined to be statistically significant compared to the rates during — ; no statistically significant difference was found in MRSA isolates between and Staphylococcus has emerged as a worldwide life-threatening hospital- and community-acquired infection factor.

The antimicrobial resistance problem in MRSA isolates in hospital infections is accompanied by high morbidity and mortality. The prevalence of MRSA infections can vary from country to country and between hospitals, and it also varies between different units of the same hospital [ 7 , 8 , 10 ]. Yilmaz et al. Haznedaroglu et al.

Aydin et al. High MRSA rates in were statistically significant compared to those of other years. We consider this case as a positive reflection of the decrease in MRSA, proper basic infection control measures, regular implementation of MRSA screening, and decolonization for individuals in high-risk group and successful MRSA education programs.

Glycopeptide antibiotics such as vancomycin are generally used in treatment against MRSA strains in Turkey and in the rest of the world. But the widespread use of vancomycin after methicillin-resistant S. Following the identification of vancomycin intermediate-resistant S. Vancomycin resistance has not been detected in several studies conducted both in Turkey and in Europe [ 10 , 18 , 22 ].

It was found that the resistance mechanism of vancomycin is mainly specific binding of vancomycinto the bacterial cell wall via peptidoglycan precursor small peptides, which are terminated with D-alanyl-D-alanine; this binding inhibits the elongation and cross-linking of bacterial cell wall peptidoglycans, thereby repressing cell wall synthesis and ultimately leading to bacterial death Micek, ; Haseeb et al. However, the resistance of Staphylococcus aureus to vancomycin is increasing daily, causing widespread concern in the medical community Haseeb et al.

Currently, a large number of researchers generally divide vancomycin-resistant Staphylococcus aureus into three types: vancomycin-resistant Staphylococcus aureus VRSA , vancomycin-intermediate Staphylococcus aureus VISA and heterologous vancomycin resistant Staphylococcus aureus hetero-VRSA Amberpet et al.

Daptomycin is a cyclized lipopeptide drug that is extracted from the fermentation broth of Streptomyces roseosporus Heidary et al. Its mechanism of action is to destroy the electric potential of the plasma membranes in the presence of calcium ions, but daptomycin does not inhibit the lipoteichoic acid Taylor and Palmer, Due to its unique mechanism of action, daptomycin has no cross-resistance with other antibiotics and can be used to treat skin soft tissue infections and bloodstream infections caused by MRSA, but not MRSA-induced pneumonia because its activity can be suppressed by alveolar surfactant Gomez Casanova et al.

Furthermore, daptomycin has the effect of resisting most clinical gram-positive bacteria in vitro; therefore, daptomycin is mainly applied to treat infections of many drug-resistant bacteria, such as vancomycin-resistant enterococci , MRSA, glycopeptide-sensitive Staphylococcus aureus , coagulase-negative Staphylococci , and penicillin-resistant Streptococcus pneumoniae Chuang et al. The United States has approved intravenous injections of daptomycin for the treatment of complex skin and soft tissue infections Heidary et al.

For the dosage form, daptomycin is currently only available in the form of an injection, and its oral dosage form is under study Mediavilla et al.

Linezolid is a synthetic, new class of oxazolidinone antibacterial agents that inhibits enterococcistaphylococci , and most strains of Streptococcus Sazdanovic et al. It is mainly used to control systemic infections caused by vancomycin-resistant Enterobacter faecium , such as sepsis, and pneumonia Krueger and Unertl, Linezolid can bind to the 23S site of ribosomal RNA on the 50S subunit in bacteria inhibiting the 50S and 30S ribosomal subunits and preventing the formation of the 70S initiation complex, thereby interfering with protein synthesis Livermore, This unique mechanism of action eliminates cross-resistance between linezolid and other antibiotics Livermore, ; Hashemian et al.

It has been reported that the survival rate and clinical cure rate of patients with MRSA infection treated with linezolid were significantly higher than those treated with vancomycin. Based on large-scale clinical studies, the oral and injection dosage forms of linezolid are equally effective in the treatment of MRSA, and are also effective against infections such as vancomycin-resistant enterococci , penicillin-resistant pneumococcal , and macrolide-resistant bacteriostatic streptococci Hashemian et al.

In view of the good therapeutic effect of the drug on multidrug resistant bacteria, it has been used clinically after being approved by the US Food and Drug Administration FDA in Tyson et al. In , linezolid also entered the Chinese market. Because it has a strong antibacterial effect on most gram-positive bacteria, it is considered to be an important choice for the treatment of MRSA Hashemian et al.

Therefore, many new drugs against MRSA are urgently needed. Table 2 lists the newly studied anti-MRSA drugs in recent years. Quorum sensing is a phenomenon in which bacterial cells regulate the behavior of bacterial populations by sensing self-inducers. Bacteria secrete signal molecules called auto-inducing substances Perez-Perez et al. When the extracellular concentration of these substances increases to a certain threshold with the concentration of the population, the bacteria turn on the expression of specific genes, thereby regulating the group behavior of the bacteria Yin et al.

This is an effective means of information exchange between bacteria, including bioluminescence, biofilm, and toxic gene expression and many other behaviors are regulated by the quorum sensing system Kalia and Purohit, The microbial pathogenic properties of S.

These virulence factors are chiefly exotoxins that disrupt host cells, interfere with immune responses, and some proteins involved in adhesion and defense against host defenses Kalia and Purohit, ; Yin et al. The expression of virulence factors is regulated by a complex network composed of multiple genes, of which agr a global regulatory factor H1, is the most important gene regulated by quorum sensing mechanisms Haseeb et al.

However, the inhibition of this quorum sensing mechanism in bacteria could result in the obstruction of biofilm formation, reduction in bacterial virulence and decreased bacterial resistance Wang et al. Lectin is a non-immune-derived sugar-binding protein that enables cell agglutination or precipitation of glycoconjugates Aretz et al.

It has been reported that lectins can not only agglutinate red blood cells, but also agglutinate with a variety of cells, such as pathogens, immune cells, and germ cells Aretz et al.

Presently, the application of lectin in the medical field is mainly the specific recognition and adhesion of lectins, which allows various pathogenic microorganisms to bind and infect their recipient cells Alghadban et al.

For example, certain mannose lectins can significantly affect the toxicity of HIV, which enables the development of antiviral drugs Barre et al. Therefore, it is possible to use the characteristics of lectin to design and develop new clinical drugs, and fundamentally prevent the binding of pathogenic microorganisms to recipient cells, thus preventing most infectious diseases Aretz et al.

Iron ions are essential nutrients for most organisms, including bacteria Carver, Studies have shown that iron ions constitute the catalytic center of important biological enzymes such as oxidoreductase, and participate in various life activities such as electron transport, antioxidant reactions, and nucleic acid synthesis Nuti et al. The antibiotic resistance of pathogenic bacteria is continuously increasing; therefore new antibacterial drugs urgently needed Borgna-Pignatti and Marsella, One of the important mechanisms of bacterial resistance is to reduce the permeability of the outer membrane and thus hinder the entry of drug molecules into the cells Carver, To circumvent the drug resistance mediated by this mechanism, one method is to attach the antibiotic molecule to an iron carrier, forming an iron carrier-antibiotic conjugate, and this iron carrier-antibiotic conjugate can selectively interact with the surface of the bacterial cell membrane Rayner and Munckhof, The iron carrier outer membrane receptors interacts with this conjugate; the conjugate then crosses the outer cell membrane by active transport through an iron ion transport system Bogdan et al.

Finally, the drug is released inside the cell, thereby exerting antibacterial action Bogdan et al. At the beginning of their discovery, phage were used by the former Soviet Union and Eastern European medical communities to treat bacterial infections Cisek et al. However, with the introduction of the antibiotic era, people gradually neglected in-depth research on phages. In recent years, due to the increasing global infection rate of drug-resistant bacteria, the use of antibiotics to treat bacterial infections has faced unprecedented challenges Lin et al.

The emergence of a series of drug-resistant pathogens such as Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, tuberculosis, Enterococcus faecalis , and especially MRSA, has led some scientists and clinicians to refocus their attention on phage research, leading to great progress in this area Lin et al.

A large number of experiments have proven that phages can effectively improve the survival rate of animals infected with bacteria Shlezinger et al. Compared with antibiotics, phage preparations have the advantages of high specificity, fast self-proliferation, and short development time Krut and Bekeredjian-Ding, Phage therapy is considered to be one of the most promising therapies against human pathogens, including antibiotic resistant strains Shlezinger et al.

As early as , phage were used to treat skin infections caused by staphylococci Wang et al. In , Italian researchers demonstrated that the phage Msa can effectively control lethal infections caused by S.

With the increase of drug-resistant bacteria, the advantages of phages have been recognized by more scholars. However, the biological characteristics of S. Similar to antibiotics, bacteria may also be resistant to phages. However, the diversity and variability of phages in nature also provide an inexhaustible resource pool for phage-controlled bacteria. In addition, phage lysing enzymes that have a destructive effect on the basic framework of bacteria can make up for the lack of phage resistance Shlezinger et al.

Moreover, at present, phage therapy is still immature in clinical application. The main problems are as follows Lin et al. Phages may be inoculated prematurely or at inappropriate doses, and may be eliminated by the body before they begin to proliferate. Therefore, determining the optimal inoculation time and dose will become a major difficulty in phage treatment. The above are common problems in phage therapy.

Therefore, these problems also exist in the course of Staphylococcus aureus treatment. Nanotechnology refers to the preparation, research and industrialization of substances at the nanoscale, as well as comprehensive technical systems for cross-research and industrialization using nanoscale materials Wu et al.

Studies have shown that nanotechnology can be applied in the fields of medicine, medicine, biology, chemistry, and information technology; therefore, it can play an important role in non-invasive minimally invasive medicine Barbero et al. In the medical field, nanoparticles enhance the ability to deliver a drugin the human body Li et al. After several layers of nanoparticle-encapsulated smart drugs enter the human body, they can actively search for and attack cancer cells or repair damaged tissues Wang et al.

China has successfully developed a new generation of nanoscale antibacterial drugs. The powdered nanoparticles are only 25 nanometers in diameter and have strong inhibition and killing effects on pathogenic microorganisms such as Escherichia coli and S. Nanoscale antibacterial drugs have many properties such as spectrum, hydrophilicity and environmental protection, and they does not produce resistance due to the use of natural minerals Howden et al. Staphylococcus aureus is a bacterium that is ubiquitous in the environment and is common in the human body on the surface of the skin and in the upper respiratory tract mucosa Lowy, In the s, penicillin was discovered by the British bacteriologist Fleming and was used in the clinic to control the S.

Later, various antibacterial drugs continued to emerge. However, this major research has also laid a hidden danger for human society. The widespread use of antibiotics has led to an increasing incidence of bacterial resistance, beginning with the emergence of multidrug resistant strains such as MRSA, which has been regarded as clinically important problem and has also attracted extensive attention from domestic and foreign research experts Pichereau and Rose, ; Klein et al.

Due to its characteristics of easy infection, high mortality and multidrug resistance, MRSA has become a stumbling block in clinical treatment Khoshnood et al. Hence, how to effectively prevent and control MRSA has become a hot topic in modern research. Over the years, science and technology have progressed, and medicine has continued to develop. Humans have made outstanding achievements in the research of pathogenic factors of MRSA.

However, the multidrug resistance of MRSA has greatly increased the difficulty of human research Vestergaard et al.

The development of new drugs has given doctors more options to treat MRSA infections, providing greater protection to human health. However, the efficacy and safety of drugs require further clinical research. YW designed the concept. YG and GS drafted the manuscript. MS collected and analyzed the literature. JW edited the manuscript and revised the language. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Crit Care 20 Suppl 2 Alghadban, S. Absence of the lectin activation pathway of complement ameliorates proteinuria-induced renal injury. Amberpet, R. Detection of heterogeneous vancomycin-intermediate Staphylococcus aureus : a preliminary report from south India. Indian J. Andrade, J. Enhancement of the antibiotic activity of aminoglycosides by alpha-tocopherol and other cholesterol derivates. In a similar study by Oie et al. Antibiotic resistance has become a notorious health concern in the twenty-first Century.

MRSA is an impediment to antimicrobial therapy, and the introduction of new classes of antimicrobial agents is usually followed by the emergence of resistant forms of this pathogen. The threat posed by MRSA was vividly demonstrated in this study, as one hospital isolate was resistant to all eight antibiotics used for the susceptibility test. Ghana is a place where poverty is prominent and people cannot afford to buy more expensive antibiotics, and the prevalence of MSRA on door handles, and particularly of theatre rooms, presents a significant threat to patients undergoing surgery.

Generally, the MSSA isolates in this study were more susceptible than the MRSA to antibiotics, but regular surveillance exercises should still be used to control the emergence of MRSA and other infectious diseases in hospitals. These drugs also consistently demonstrate in vitro activity against S.

Hammuel et al. This is the first study conducted on S. There were high levels of contamination of S. Isolates of S. There is a need for periodic surveillance and monitoring of S. This study provides preliminary information for the control of infections in the three hospitals studied. Further studies are needed, not only in Ghana, but across Africa, to understand the extent to which S.

Molecular epidemiology of Methicillin-resistant Staphylococcus aureus in Africa: a systematic review. Front Microbiol. Google Scholar. Hand hygiene practices in a neonatal intensive care unit in Ghana. J Infect Dev Ctries. Assessing hand hygiene resources and practices at a large African teaching hospital. Infect Control Hosp Epidemiol. Article Google Scholar. Rayner C, Munckhof WJ. Antibiotics currently used in the treatment of infections caused by Staphylococcus aureus. Intern Med J. Newman MJ.

Neonatal intensive care unit: reservoirs of nosocomial pathogens. West Afr J Med. PubMed Google Scholar. Prevalence and antibiogram pattern of some nosocomial pathogens isolated from Hospital Environment in Zaria, Nigeria. Aceh Int J Sci Technol. Ghana Med J. Deaths: preliminary data for Natl Vital Stat Rep. Prevalence of methicillin-resistant Staphylococcus aureus in eight African hospitals and Malta. Clin Microbiol Infect. Susceptibility of bacterial etiological agents to commonly-used antimicrobial agents in children with sepsis at the Tamale Teaching Hospital.

BMC Infect Dis. Bacterial contamination of donor blood at the Tamale Teaching Hospital, Ghana.