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Why Has Methicillin-Resistant Staphylococcus aureus Become Such a Successful Pathogen in Adults?

Moellering, Robert C. Jr MD

Infectious Diseases in Clinical Practice: September 2010 - Volume 18 - Issue 5 - p 286-291
doi: 10.1097/IPC.0b013e3181efebca
NFID Clinical Updates

Staphylococcus aureus is a pathogen that has caused human disease for centuries, and despite efforts to control it via modern antibiotics, this organism has persisted and continues to cause major clinical problems throughout the world. A remarkably versatile pathogen, it has virulence mechanisms that enable it to cause a broad variety of serious infections in man, and it has the ability to acquire new exogenous genes, which make it possible for it to adapt to a variety of changing environmental conditions and to modulate its pathogenicity. It can establish a symptomatic carriage that permits widespread dissemination. It has shown a remarkable ability to develop resistance to the major antibiotics directed against it including the penicillins. The development of methicillin resistance in staphylococci has resulted in organisms that continue to plague patients in institutionalized settings and elsewhere. More recently, there has been a worldwide outbreak (currently most prominent in the United States) of infections due to community-associated methicillin-resistant staphylococci. The factors that have made it possible for this to occur are defined in this article.

From the Harvard Medical School, Boston, MA.

Correspondence to: Robert C. Moellering, Jr, MD, Harvard University Medical School, 110 Francis St, Suite 6A1102 Bates Ave, Suite 1120, Boston, MA 02215. E-mail:

The author served as an advisor or consultant for Cubist Pharmaceuticals, Inc; Pfizer Inc; Wyeth; and Theravance.

This CME activity is supported by an unrestricted educational grant from Cubist Pharmaceuticals.

© 2010 Lippincott Williams & Wilkins, Inc.