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Colonization, pathogenicity, host susceptibility, and therapeutics for Staphylococcus aureus: what is the clinical relevance?

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Staphylococcus aureus is a human commensal that can also cause a broad spectrum of clinical disease. Factors associated with clinical disease are myriad and dynamic and include pathogen virulence, antimicrobial resistance, and host susceptibility. Additionally, infection control measures aimed at the environmental niches of S. aureus and therapeutic advances continue to impact upon the incidence and outcomes of staphylococcal infections. This review article focuses on the clinical relevance of advances in our understanding of staphylococcal colonization, virulence, host susceptibility, and therapeutics. Over the past decade key developments have arisen. First, rates of nosocomial methicillin-resistant S. aureus (MRSA) infections have significantly declined in many countries. Second, we have made great strides in our understanding of the molecular pathogenesis of S. aureus in general and community-associated MRSA in particular. Third, host risk factors for invasive staphylococcal infections, such as advancing age, increasing numbers of invasive medical interventions, and a growing proportion of patients with healthcare contact, remain dynamic. Finally, several new antimicrobial agents active against MRSA have become available for clinical use. Humans and S. aureus co-exist, and the dynamic interface between host, pathogen, and our attempts to influence these interactions will continue to rapidly change. Although progress has been made in the past decade, we are likely to face further surprises such as the recent waves of community-associated MRSA.

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Acknowledgments

Dr. Tong is supported by an Australian National Health and Medical Research Council Postdoctoral Training Fellowship (508829), an Australian-American Fulbright Scholarship, and a Royal Australasian College of Physicians Bayer Australia Medical Research Fellowship. Dr. Chen is a co-investigator in the Centers for Disease Control and Prevention and Duke University Prevention Epicenter Program. Dr. Fowler was supported by K24-AI093969 and R01-AI068804.

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Authors and Affiliations

  1. Division of Infectious Diseases and International Health, Duke University Medical Center, Box 102359, Durham, NC, 27705, USA

    Steven Y. C. Tong, Luke F. Chen & Vance G. Fowler Jr

  2. Menzies School of Health Research, Darwin, Northern Territory, Australia

    Steven Y. C. Tong

  3. Duke University Prevention Epicenter, Durham, NC, USA

    Luke F. Chen

  4. Duke Clinical Research Institute, Durham, NC, USA

    Vance G. Fowler Jr

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  1. Steven Y. C. Tong
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  2. Luke F. Chen
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  3. Vance G. Fowler Jr
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Correspondence to Steven Y. C. Tong.

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This article is published as part of the Special Issue on Immunopathology of Staphylococcal infections [34:3].

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Tong, S.Y.C., Chen, L.F. & Fowler, V.G. Colonization, pathogenicity, host susceptibility, and therapeutics for Staphylococcus aureus: what is the clinical relevance?. Semin Immunopathol 34, 185–200 (2012). https://doi.org/10.1007/s00281-011-0300-x

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