Epidemiology, Virulence Factors and Antimicrobial Resistance in Staphylococcus aureus

Dear Colleagues,

Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of healthcare-associated (HA-MRSA) infections, and its prevalence is also increasing in community-associated (CA-MRSA) infections. In addition to resistance to beta-lactams, S. aureus has shown resistance to other classes of antimicrobials, especially the glycopeptide vancomycin, a drug considered as the main alternative in the treatment of infections by MRSA. Currently, newly developed drugs can treat these resistant staphylococci, but there are already reports of reduced sensitivity to them. The variety of S. aureus species causing infections is largely due to the wide variety of virulence factors encoded by these bacteria, including toxins (hemolysins, leukocidins and superantigens), antiphagocytic factors (capsule and protein A) and enzymes associated with obtaining energy and disseminating the microorganism in the host (proteases, nucleases, hyaluronidase, lipases and collagenases), which favors the invasion of different tissues and evasion of the host's immune system. S. aureus infections may also be associated with biofilm formation, which facilitates the adherence of the microorganism to biotic or abiotic surfaces and provides protection against host defense mechanisms and antimicrobial action. Genetically diverse, the epidemiology of MRSA is primarily characterized by the serial emergence of epidemic strains. Although its incidence has recently declined in some regions, MRSA still poses a formidable clinical threat, with persistently high morbidity and mortality. The constant monitoring of these profiles of resistance to antimicrobials and antiseptics, as well as the knowledge of the prevalent and circulating clonal profiles in hospitals, is extremely important for the direction of empirical therapies. In addition to this, the increased use of antimicrobial agents during the COVID-19 pandemic, due to the need to implement mechanical ventilation and the use of invasive medical devices in some patients affected by SARS-COV-2, may intensify the selective pressure on microorganisms present in hospital environments, impacting the emergence of multi-resistant S. aureus. Successful treatment remains challenging and requires the evaluation of both novel antimicrobials and adjunctive aspects of care and source control. This Special Issue seeks manuscript submissions that further our understanding of basic and clinical S. aureus research about epidemiology, transmission, genetic diversity, evolution, virulence factors, surveillance and treatment.

Prof. Dr. Maria de Lourdes Ribeiro de Souza da Cunha
Guest Editor

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