TRENDS in Microbiology
Vol.12 No.8 August 2004
Staphylococcus aureus: superbug, super genome?
Jodi A. Lindsay1 and Matthew T.G. Holden2
Department of Cellular & Molecular Medicine, St George’s Hospital Medical School, Cranmer Terrace, London, UK SW17 0RE The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK CB10 1SA
Staphylococcus aureus is a common cause of infection in both hospitals and the community, and it is becoming increasingly virulent and resistant to antibiotics. The recent sequencing of seven strains of S. aureus provides unprecedented information about its genome diversity. Subtle differences in core (stable) regions of the genome have been exploited by multi-locus sequence typing (MLST) to understand S. aureus population structure. Dramatic differences in the carriage and spread of accessory genes, including those involved in virulence and resistance, contribute to the emergence of new strains with healthcare implications. Understanding the differences between S. aureus genomes and the controls that govern these changes is helping to improve our knowledge of S. aureus pathogenicity and to predict the evolution of super-superbugs. Staphylococcus aureus is the most common cause of hospital-acquired infection, causing clinical disease in 2% of all patient admissions, and is becoming increasingly resistant to antibiotics. In several industrialized nations, including parts of Europe, the USA and Japan, 40 –60% of all hospital S. aureus are now resistant to methicillin (methicillin-resistant Staphylococcus aureus; MRSA) . Although MRSA strains were ﬁrst described in the 1960s, they did not spread rapidly until the late 1980s to mid 1990s, whereupon they are now endemic in hospitals and cannot be eradicated. MRSA infections are treated with vancomycin, but the ﬁrst vancomycin intermediate-level resistant isolates (VISA or GISA) were described in 1997 . Of greater concern, there have been...