Staphylococcus aureus – Infection, MRSA & Treatment
Staphylococcus aureus is a gram-positive bacterium and one of the most common causes of skin, wound, and respiratory infections. Resistant strains such as MRSA pose a serious public health challenge.
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Staphylococcus aureus is a gram-positive bacterium and one of the most common causes of skin, wound, and respiratory infections. Resistant strains such as MRSA pose a serious public health challenge.
What is Staphylococcus aureus?
Staphylococcus aureus (abbreviated S. aureus) is a spherical, gram-positive bacterium belonging to the Staphylococcaceae family. It is one of the most significant bacterial pathogens in humans and naturally colonises the skin and mucous membranes of the nose and throat. Approximately 20–30% of the general population carry S. aureus without developing any symptoms (asymptomatic colonisation).
Causes and Transmission
S. aureus is primarily transmitted through direct contact with infected individuals or contaminated surfaces. It poses a particular risk in hospital and care settings. Common routes of transmission include:
- Direct skin-to-skin contact with carriers or infected individuals
- Contact with contaminated objects or surfaces (contact transmission)
- Droplet transmission via coughing or sneezing
- Contaminated food containing staphylococcal enterotoxins
Symptoms and Clinical Manifestations
S. aureus can cause a wide spectrum of infections, ranging from minor skin conditions to life-threatening systemic illness:
- Skin infections: Furuncles, carbuncles, impetigo, and wound infections
- Respiratory infections: Pneumonia, especially following influenza
- Bone infections: Osteomyelitis
- Heart valve infection: Endocarditis
- Bloodstream infection: Sepsis – a potentially fatal systemic condition
- Toxic Shock Syndrome (TSS): Caused by staphylococcal toxins, presenting with high fever, shock, and organ failure
- Food poisoning: Resulting from preformed toxins in contaminated food
Diagnosis
Diagnosis of S. aureus infection is primarily made through microbiological testing. Swabs, blood, urine, or wound samples are analysed in a laboratory. Common diagnostic methods include:
- Bacterial culture: Growing the organism on culture media for definitive identification
- Gram staining: Microscopic examination for initial classification
- PCR testing: Molecular rapid detection, particularly used for MRSA screening
- Antibiogram: Assessment of antibiotic sensitivity to guide treatment decisions
Treatment
Treatment depends on the type and severity of the infection and the antibiotic susceptibility of the identified strain:
- Penicillinase-resistant penicillins (e.g., flucloxacillin) are the first-line treatment for susceptible S. aureus strains.
- First-generation cephalosporins may be used as an alternative.
- For MRSA (Methicillin-resistant S. aureus), reserve antibiotics such as vancomycin, linezolid, or daptomycin are required.
- Local skin and wound infections may also require surgical intervention, such as incision and drainage of abscesses.
MRSA – Methicillin-Resistant Staphylococcus aureus
MRSA refers to strains of S. aureus that have developed resistance to most commonly used antibiotics. MRSA infections are particularly dangerous and are classified as hospital-acquired (HA-MRSA) or community-acquired (CA-MRSA). Strict hygiene protocols and systematic screening programmes are essential for controlling its spread.
Prevention
The following measures are recommended to reduce the risk of S. aureus infection:
- Regular and thorough handwashing with soap and water
- Proper wound disinfection and care
- Adherence to hygiene guidelines in healthcare settings
- Avoiding sharing personal items such as towels or razors
- Safe food handling, preparation, and storage practices
References
- Lowy FD. Staphylococcus aureus infections. New England Journal of Medicine. 1998;339(8):520–532. DOI: 10.1056/NEJM199808203390806
- World Health Organization (WHO): Antimicrobial Resistance – Global Action Plan. Geneva, 2015. Available at: www.who.int
- Tong SYC, Davis JS, Eichenberger E, Holland TL, Fowler VG Jr. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clinical Microbiology Reviews. 2015;28(3):603–661. DOI: 10.1128/CMR.00134-14
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