Division of Infectious Diseases, Akron General Medical Center, Akron, OH 44302, USA.
Departments of Medicine and Health Studies, The University of Chicago, Chicago, IL, USA.
J Med Microbiol. 2012 Sep;61(Pt 9):1179-1193. doi: 10.1099/jmm.0.043513-0. Epub 2012 Jun 28.
Meticillin-resistant Staphylococcus aureus (MRSA) strains are prevalent bacterial pathogens that cause both health care and community-associated infections. Increasing resistance to commonly prescribed antibiotics has made MRSA a serious threat to public health throughout the world. The USA300 strain of MRSA has been responsible for an epidemic of community-associated infections in the US, mostly involving skin and soft tissue but also more serious invasive syndromes such as pneumonia, severe sepsis and endocarditis. MRSA strains are particularly serious and potentially lethal pathogens that possess virulence mechanisms including toxins, adhesins, enzymes and immunomodulators. One of these is Panton-Valentine leukocidin (PVL), a toxin associated with abscess formation and severe necrotizing pneumonia. Earlier studies suggested that PVL was a major virulence factor in community-associated MRSA infections. However, some recent data have not supported this association while others have, leading to controversy. Therefore, investigators continue to search for additional mechanisms of pathogenesis. In this review, we summarize the current understanding of the biological basis of MRSA virulence and explore future directions for research, including potential vaccines and antivirulence therapies under development that might allow clinicians to more successfully treat and prevent MRSA infections.
耐甲氧西林金黄色葡萄球菌（MRSA）菌株是一种流行的细菌病原体，可引起医疗保健和社区相关感染。对常用抗生素的耐药性增加使 MRSA 成为全球公共卫生的严重威胁。USA300 型 MRSA 菌株已导致美国社区相关感染的流行，主要涉及皮肤和软组织，但也更严重的侵袭性综合征，如肺炎、严重败血症和心内膜炎。MRSA 菌株是特别严重和潜在致命的病原体，具有包括毒素、黏附素、酶和免疫调节剂在内的毒力机制。其中一种是 Panton-Valentine 白细胞毒素（PVL），一种与脓肿形成和严重坏死性肺炎相关的毒素。早期研究表明，PVL 是社区相关 MRSA 感染的主要毒力因子。然而，一些最近的数据并不支持这种关联，而另一些则支持，这导致了争议。因此，研究人员继续寻找发病机制的其他机制。在这篇综述中，我们总结了对 MRSA 毒力的生物学基础的现有认识，并探讨了未来的研究方向，包括正在开发的潜在疫苗和抗病毒治疗方法，这可能使临床医生能够更成功地治疗和预防 MRSA 感染。
