Abstract
Treatment and complete resolution of MRSA infections can be extremely challenging, since many MRSA strains are multidrug-resistant. This 6-page fact sheet provides an overview of MRSA, different strains, risk factors, symptoms, prevention, and the pathogen’s effects on human health and agriculture. Written by Austin B. Mogen and Kelly C. Rice, and published by the UF Department of Microbiology and Cell Science, September 2015.
References
Archer, G. L. 1998. "Staphylococcus aureus: a well-armed pathogen." Clin. Infect. Dis. 26: 1179-1181. https://doi.org/10.1086/520289
Archibald, L. K., J. Shapiro, A. Pass, K. Rand, and F. Southwick. 2008. "Methicillin-resistant Staphylococcus aureus infection in a college football team: Risk factors outside the locker room and playing field." Infect. Control Hosp. Epidemiol. 29: 450-453. https://doi.org/10.1086/587971
Ballhausen, B., P. Jung, A. Kriegeskorte, P. E. Makgotlho, U. Ruffing, L. von Muller, R. Kock, G. Peters, M. Herrmann, W. Ziebuhr, K. Becker, and M. Bischoff. 2014. "LA-MRSA CC398 differ from classical community acquired-MRSA and hospital acquired-MRSA lineages: Functional analysis of infection and colonization processes." Int. J. Med. Microbiol. 304: 777-786. https://doi.org/10.1016/j.ijmm.2014.06.006
Bhat, M., C. Dumortier, B. S. Taylor, M. Miller, G. Vasquez, J. Yunen, K. Brudney, E. J. Sanchez, C. Rodriguez-Taveras, R. Rojas, P. Leon, and F. D. Lowy. 2009. "Staphylococcus aureus ST398, New York City and Dominican Republic." Emerg. Infect. Dis. 15: 285-287. https://doi.org/10.3201/eid1502.080609
Boucher, H. W., and G. R. Corey. 2008. "Epidemiology of methicillin-resistant Staphylococcus aureus." Clin. Infect. Dis. 46, Suppl. 5: S344-349. https://doi.org/10.1086/533590
CBS News and Associated Press. 2013. "MRSA infects third NFL player on Tampa Bay Buccaneers." Accessed on January 9, 2016. http://www.cbsnews.com/news/mrsa-infects-third-nfl-player-on-tampa-bay-buccaneers/.
CDC. 2012. "Active Bacterial Core Surveillance Report, Emerging Infections Program Network, Methicillin-Resistant Staphylococcus aureus, Centers for Disease Control and Prevention." Accessed on January 9, 2016. http://www.cdc.gov/abcs/reports-findings/survreports/mrsa12.pdf.
CDC. 2016. "Methicillin-resistant Staphylococcus aureus (MRSA) infections." Accessed on January 9, 2016. http://www.cdc.gov/mrsa/community/index.html#q4.
Cha, E., D. Bar, J. A. Hertl, L. W. Tauer, G. Bennett, R. N. Gonzalez, Y. H. Schukken, F. L. Welcome, and Y. T. Grohn. 2011. "The cost and management of different types of clinical mastitis in dairy cows estimated by dynamic programming." J. Dairy Sci. 94: 4476-4487. https://doi.org/10.3168/jds.2010-4123
Christiansen, M. T., R. S. Kaas, R. R. Chaudhuri, M. A. Holmes, H. Hasman, and F. M. Aarestrup. 2014. "Genome-wide high-throughput screening to investigate essential genes involved in methicillin-resistant Staphylococcus aureus Sequence Type 398 survival." PLoS One 9: e89018. https://doi.org/10.1371/journal.pone.0089018
Dantes, R., Y. Mu, R. Belflower, D. Aragon, G. Dumyati, L. H. Harrison, F. C. Lessa, R. Lynfield, J. Nadle, S. Petit, S. M. Ray, W. Schaffner, J. Townes, and S. Fridkin. 2013. "National burden of invasive methicillin-resistant Staphylococcus aureus infections, United States, 2011." JAMA Intern. Med. 173: 1970-1978.
De Vliegher, S., L. K. Fox, S. Piepers, S. McDougall, and H. W. Barkema. 2012. "Invited review: Mastitis in dairy heifers: nature of the disease, potential impact, prevention, and control." J. Dairy Sci. 95: 1025-1040. https://doi.org/10.3168/jds.2010-4074
DeGraves, F. J., and J. Fetrow. 1993. "Economics of mastitis and mastitis control." Vet. Clin. North Am. Food Anim. Pract. 9: 421-434. https://doi.org/10.1016/S0749-0720(15)30611-3
Florida Department of Health. 2015. "Florida Morbidity Statistics Report 2013." Accessed on January 9, 2016. http://www.floridahealth.gov/diseases-and-conditions/disease-reporting-and-management/disease-reporting-and-surveillance/data-and-publications/fl-amsr1.html#2013
Florida Department of Health. 2016. "Methicillin resistant Staphylococcus aureus (MRSA)." Accessed on January 9, 2016. http://www.floridahealth.gov/diseases-and-conditions/methicillin-resistant-staphylococcus-aureus/index.html.
Foster, A. P. 2012. "Staphylococcal skin disease in livestock." Vet. Dermatol. 23: 342-351, e363. https://doi.org/10.1111/j.1365-3164.2012.01093.x
Gardete, S., and A. Tomasz. 2014. "Mechanisms of vancomycin resistance in Staphylococcus aureus." J. Clin. Invest. 124: 2836-2840. https://doi.org/10.1172/JCI68834
Golding, G. R., L. Bryden, P. N. Levett, R. R. McDonald, A. Wong, M. R. Graham, S. Tyler, G. Van Domselaar, P. Mabon, H. Kent, P. Butaye, T. C. Smith, K. Kadlec, S. Schwarz, S. J. Weese, and M. R. Mulvey. 2012. "Whole-genome sequence of livestock-associated ST398 methicillin-resistant Staphylococcus aureus isolated from humans in Canada." J. Bacteriol. 194: 6627-6628. https://doi.org/10.1128/JB.01680-12
Gordon, R. J., and F. D. Lowy. 2008. "Pathogenesis of methicillin-resistant Staphylococcus aureus infection." Clin. Infect. Dis. 46, Suppl. 5: S350-359. https://doi.org/10.1086/533591
Gorwitz, R. J., D. Kruszon-Moran, S. K. McAllister, G. McQuillan, L. K. McDougal, G. E. Fosheim, B. J. Jensen, G. Killgore, F. C. Tenover, and M. J. Kuehnert. 2008. "Changes in the prevalence of nasal colonization with Staphylococcus aureus in the United States, 2001-2004." J. Infect. Dis. 197: 1226-1234. https://doi.org/10.1086/533494
Howden, B. P., J. K. Davies, P. D. Johnson, T. P. Stinear, and M. L. Grayson. 2010. "Reduced vancomycin susceptibility in Staphylococcus aureus, including vancomycin-intermediate and heterogeneous vancomycin-intermediate strains: Resistance mechanisms, laboratory detection, and clinical implications." Clin. Microbiol. Rev. 23: 99-139. https://doi.org/10.1128/CMR.00042-09
Jevons, M. P. 1961. ""Celbenin"-resistant staphylococci." Br. Med. J. 1: 124-125. https://doi.org/10.1136/bmj.1.5219.124-a
Jevons, M. P., A. W. Coe, and M. T. Parker. 1963. "Methicillin resistance in staphylococci." Lancet 1: 904-907. https://doi.org/10.1016/S0140-6736(63)91687-8
Kluytmans, J., A. van Belkum, and H. Verbrugh. 1997. "Nasal carriage of Staphylococcus aureus: Epidemiology, underlying mechanisms, and associated risks." Clin. Microbiol. Rev. 10: 505-520. https://doi.org/10.1128/CMR.10.3.505
Loffler, B., L. Tuchscherr, S. Niemann, and G. Peters. 2014. "Staphylococcus aureus persistence in non-professional phagocytes." Int. J. Med. Microbiol. 304: 170-176. https://doi.org/10.1016/j.ijmm.2013.11.011
Mediavilla, J. R., L. Chen, A. C. Uhlemann, B. M. Hanson, M. Rosenthal, K. Stanak, B. Koll, B. C. Fries, D. Armellino, M. E. Schilling, D. Weiss, T. C. Smith, F. D. Lowy, and B. N. Kreiswirth. 2012. "Methicillin-susceptible Staphylococcus aureus ST398, New York and New Jersey, USA." Emerg. Infect. Dis. 18: 700-702. https://doi.org/10.3201/eid1804.111419
Mendes, R. E., T. C. Smith, L. Deshpande, D. J. Diekema, H. S. Sader, and R. N. Jones. 2011. "Plasmid-borne vga(A)-encoding gene in methicillin-resistant Staphylococcus aureus ST398 recovered from swine and a swine farmer in the United States." Diagn. Microbiol. Infect. Dis. 71: 177-180. https://doi.org/10.1016/j.diagmicrobio.2011.06.009
Otto, M. 2013. "Staphylococcal infections: mechanisms of biofilm maturation and detachment as critical determinants of pathogenicity." Annu. Rev. Med. 64: 175-188. https://doi.org/10.1146/annurev-med-042711-140023
Plano, L. R., T. Shibata, A. C. Garza, J. Kish, J. M. Fleisher, C. D. Sinigalliano, M. L. Gidley, K. Withum, S. M. Elmir, S. Hower, C. R. Jackson, J. B. Barrett, T. Cleary, M. Davidson, J. Davis, S. Mukherjee, L. E. Fleming, and H. M. Solo-Gabriele. 2013. "Human-associated methicillin-resistant Staphylococcus aureus from a subtropical recreational marine beach." Microb. Ecol. 65: 1039-1051. https://doi.org/10.1007/s00248-013-0216-1
Price, L. B., M. Stegger, H. Hasman, M. Aziz, J. Larsen, P. S. Andersen, T. Pearson, A. E. Waters, J. T. Foster, J. Schupp, J. Gillece, E. Driebe, C. M. Liu, B. Springer, I. Zdovc, A. Battisti, A. Franco, J. Zmudzki, S. Schwarz, P. Butaye, E. Jouy, C. Pomba, M. C. Porrero, R. Ruimy, T. C. Smith, D. A. Robinson, J. S. Weese, C. S. Arriola, F. Yu, F. Laurent, P. Keim, R. Skov, and F. M. Aarestrup. 2012. "Staphylococcus aureus CC398: host adaptation and emergence of methicillin resistance in livestock." MBio. 3, no. 1. https://doi.org/10.1128/mBio.00305-11
Rammelkamp, C. H., and T. Maxon. 1942. "Resistance of Staphylococcus aureus to the action of penicillin." Proc. R. Soc. Exp. Biol. Med. 51: 386-389. https://doi.org/10.3181/00379727-51-13986
Rihn, J. A., M. G. Michaels, and C. D. Harner. 2005. "Community-acquired methicillin-resistant Staphylococcus aureus: An emerging problem in the athletic population." Am. J. Sports Med. 33: 1924-1929. https://doi.org/10.1177/0363546505283273
Roundtree, P. M., and B. M. Freeman. 1956. "Infections caused by a particular phage type of Staphylococcus aureus." Med. J. Aust. 42: 157-161. https://doi.org/10.5694/j.1326-5377.1955.tb35001.x
Schijffelen, M. J., C. H. Boel, J. A. van Strijp, and A. C. Fluit. 2010. "Whole genome analysis of a livestock-associated methicillin-resistant Staphylococcus aureus ST398 isolate from a case of human endocarditis." BMC Genomics 11: 376. https://doi.org/10.1186/1471-2164-11-376
Smith, T. C., M. J. Male, A. L. Harper, J. S. Kroeger, G. P. Tinkler, E. D. Moritz, A. W. Capuano, L. A. Herwaldt, and D. J. Diekema. 2009. "Methicillin-resistant Staphylococcus aureus (MRSA) strain ST398 is present in midwestern U.S. swine and swine workers." PLoS One 4: e4258. https://doi.org/10.1371/journal.pone.0004258
Somerville, G. A., and R. A. Proctor. 2009. "At the crossroads of bacterial metabolism and virulence factor synthesis in staphylococci." Microbiol. Mol. Biol. Rev. 73: 233-248. https://doi.org/10.1128/MMBR.00005-09
Stroud, R., and G. Auman. 2015. "Lawrence Tynes sues Bucs for $20 million for MRSA infection." Accessed on January 9, 2016. http://www.tampabay.com/sports/football/bucs/lawrence-tynes-sues-bucs-for-20-million-for-mrsa-infection/2224407
Thurlow, L. R., G. S. Joshi, and A. R. Richardson. 2012. "Virulence strategies of the dominant USA300 lineage of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA)." FEMS Immunol. Med. Microbiol. 65: 5-22. https://doi.org/10.1111/j.1574-695X.2012.00937.x
Tuchscherr, L., V. Heitmann, M. Hussain, D. Viemann, J. Roth, C. von Eiff, G. Peters, K. Becker, and B. Loffler. 2010. "Staphylococcus aureus small-colony variants are adapted phenotypes for intracellular persistence." J. Infect. Dis. 202: 1031-1040. https://doi.org/10.1086/656047
Tuchscherr, L., E. Medina, M. Hussain, W. Volker, V. Heitmann, S. Niemann, D. Holzinger, J. Roth, R. A. Proctor, K. Becker, G. Peters, and B. Loffler. 2011. "Staphylococcus aureus phenotype switching: An effective bacterial strategy to escape host immune response and establish a chronic infection." EMBO Mol. Med. 3: 129-141. https://doi.org/10.1002/emmm.201000115
Uhlemann, A. C., C. Hafer, B. A. Miko, M. G. Sowash, S. B. Sullivan, Q. Shu, and F. D. Lowy. 2013. "Emergence of sequence type 398 as a community- and healthcare-associated methicillin-susceptible Staphylococcus aureus in northern Manhattan." Clin. Infect. Dis. 57: 700-703. https://doi.org/10.1093/cid/cit375
USDA-APHIS. 2007. "Prevalence of contagious mastitis pathogens on US dairy operations." 2007 APHIS Veterinary Services Info Sheet #N533.1008: Washington, DC.
Witte, W., B. Strommenger, C. Stanek, and C. Cuny. 2007. "Methicillin-resistant Staphylococcus aureus ST398 in humans and animals, Central Europe." Emerg. Infect. Dis. 13: 255-258. https://doi.org/10.3201/eid1302.060924
Wulf, M., and A. Voss. 2008. "MRSA in livestock animals-An epidemic waiting to happen?" Clin. Microbiol. Infect. 14: 519-521. https://doi.org/10.1111/j.1469-0691.2008.01970.x
Wulf, M. W., C. M. Verduin, A. van Nes, X. Huijsdens, and A. Voss. 2012. "Infection and colonization with methicillin-resistant Staphylococcus aureus ST398 versus other MRSA in an area with a high density of pig farms." Eur. J. Clin. Microbiol. Infect. Dis. 31: 61-65. https://doi.org/10.1007/s10096-011-1269-z