Virulence attributes of successful methicillin-resistant Staphylococcus aureus lineages

Methicillin-resistant (MRSA) is a leading cause of severe and often fatal infections. MRSA epidemics have occurred in waves, whereby a previously successful lineage has been replaced by a more fit and better adapted lineage. Selection pressures in both hospital and community settings are not uniform...

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Bibliographic Details
Published in:Clinical microbiology reviews 2023-12, Vol.36 (4), p.e0014822
Main Authors: Jiang, Jhih-Hang, Cameron, David R, Nethercott, Cara, Aires-de-Sousa, Marta, Peleg, Anton Y
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents
Bacteriology
Community-Acquired Infections
Exotoxins - genetics
Exotoxins - metabolism
Humans
Methicillin-Resistant Staphylococcus aureus - genetics
Review
Staphylococcal Infections - drug therapy
Staphylococcal Infections - epidemiology
Staphylococcus aureus
Virulence
Virulence Factors - genetics
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Summary:Methicillin-resistant (MRSA) is a leading cause of severe and often fatal infections. MRSA epidemics have occurred in waves, whereby a previously successful lineage has been replaced by a more fit and better adapted lineage. Selection pressures in both hospital and community settings are not uniform across the globe, which has resulted in geographically distinct epidemiology. This review focuses on the mechanisms that trigger the establishment and maintenance of current, dominant MRSA lineages across the globe. While the important role of antibiotic resistance will be mentioned throughout, factors which influence the capacity of to colonize and cause disease within a host will be the primary focus of this review. We show that while MRSA possesses a diverse arsenal of toxins including alpha-toxin, the success of a lineage involves more than just producing toxins that damage the host. Success is often attributed to the acquisition or loss of genetic elements involved in colonization and niche adaptation such as the arginine catabolic mobile element, as well as the activity of regulatory systems, and shift metabolism accordingly (e.g., the accessory genome regulator, ). Understanding exactly how specific MRSA clones cause prolonged epidemics may reveal targets for therapies, whereby both core (e.g., the alpha toxin) and acquired virulence factors (e.g., the Panton-Valentine leukocidin) may be nullified using anti-virulence strategies.
ISSN:0893-8512
1098-6618
1098-6618
DOI:10.1128/cmr.00148-22