Emergence and resurgence of meticillin-resistant Staphylococcus aureus as a public-health threat.
Staphylococcus aureus is a gram-positive bacterium that colonises the skin and is present in the anterior nares in about 25-30% of healthy people. Dependent on its intrinsic virulence or the ability of the host to contain its opportunistic behaviour, S aureus can cause a range of diseases in man. The bacterium readily acquires resistance against all classes of antibiotics by one of two distinct mechanisms: mutation of an existing bacterial gene or horizontal transfer of a resistance gene from another bacterium. Several mobile genetic elements carrying exogenous antibiotic resistance genes might mediate resistance acquisition. Of all the resistance traits S aureus has acquired since the introduction of antimicrobial chemotherapy in the 1930s, meticillin resistance is clinically the most important, since a single genetic element confers resistance to the most commonly prescribed class of antimicrobials--the beta-lactam antibiotics, which include penicillins, cephalosporins, and carbapenems.
Grundmann
Hajo
H
Centre for Infectious Diseases Epidemiology, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Aires-de-Sousa
Marta
M
Boyce
John
J
Tiemersma
Edine
E
D001315:Australia / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D024901:Drug Resistance, Multiple, Bacterial; D014943:Global Health; D006235:Hand Disinfection / Q000379:methods; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D016106:Methicillin Resistance; D015995:Prevalence; D011634:Public Health / Q000639:trends*; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification