Review of the Causes, Diagnosis, and Treatment of Mrsa Infections

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Ali Mohammadimoshganbar
Gholamreza Mostafavi
Amin Hoorandghadim


Antibiotics are a class of drugs that help to cure bacterial infections by killing or stopping the growth of bacteria that are causing these infections. Antibiotics revolutionized modern medicine, as they were first introduced in the late 19th century and have since saved countless lives from bacterial infections. However, the indiscriminate use of antibiotics has led to the emergence of antibiotic-resistant bacteria that can no longer be treated with commonly used antibiotics. Antibiotic resistance is now a major public health concern worldwide, as it poses a significant threat to human health. In this article, we will discuss the causes, consequences, diagnosis method and possible solutions and treatment to Methicillin-resistant Staphylococcus aureus (MRSA).
Antibiotic resistance occurs when bacteria develop mechanisms that allow them to survive in the presence of antibiotics. The resistance can be intrinsic, which means that the bacteria naturally possess genes that confer resistance, or acquired, meaning that bacteria acquire resistance genes from other bacteria. Bacteria acquire resistance genes through horizontal gene transfer, which can be mediated by plasmids, transposons, or bacteriophages. The resistant bacteria then become the dominant population that can spread and cause infections that cannot be cured by antibiotics.
Antibiotic resistance has been recognized as a global health crisis, and it is on the rise due to a combination of factors, including overuse, misuse, and poor regulation of antibiotics in human(1) and veterinary medicine, agriculture, and the environment(2,3,4,5). It is estimated that up to 50% of antibiotics prescribed for humans are unnecessary or inappropriate, and the same is true for livestock and pets. In agriculture, antibiotics are widely used as growth promoters and prophylaxis for infectious diseases in food-producing animals, which can result in the selection and spread of antibiotic-resistant bacteria in animals and the environment. The use of antibiotics in aquaculture and crop production also contributes to the dissemination of resistant bacteria.
Methicillin-resistant Staphylococcus aureus, commonly known as MRSA, is a type of bacteria that is resistant to commonly used antibiotics such as methicillin, penicillin, amoxicillin, and oxacillin. This strain of bacteria was first identified in the 1960s and has since become a major public health concern worldwide(6,7,8).

MRSA is a serious infection that requires immediate medical attention. With the increasing prevalence of the disease, it is important to understand its causes, symptoms,  treatments and preventive measures.

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How to Cite
Ali Mohammadimoshganbar, Gholamreza Mostafavi, & Amin Hoorandghadim. (2023). Review of the Causes, Diagnosis, and Treatment of Mrsa Infections. Journal of Coastal Life Medicine, 11(2), 1610–1617. Retrieved from


Lohan K, Sangwan J, Mane P, Lathwal S. Prevalence pattern of MRSA from a rural medical college of North India: A cause of concern. J Family Med Prim Care. 2021 Feb;10(2):752-757. doi: 10.4103/jfmpc.jfmpc_1527_20. Epub 2021 Feb 27. PMID: 34041072; PMCID: PMC8138351.

Devriese LA, Van Damme LR, Fameree L. Methicillin (cloxacillin)‐resistant Staphylococcus aureus strains isolated from bovine mastitis cases. Zentralblatt für Veterinärmedizin Reihe B. 1972 Sep;19(7):598-605.

Weese JS. Methicillin-resistant Staphylococcus aureus in animals. ILAR journal. 2010 Jan 1;51(3):233-44.

Dorado-García A, Bos ME, Graveland H, Van Cleef BA, Verstappen KM, Kluytmans JA, Wagenaar JA, Heederik DJ. Risk factors for persistence of livestock-associated MRSA and environmental exposure in veal calf farmers and their family members: an observational longitudinal study. BMJ open. 2013 Sep 1;3(9):e003272.

Baquero F, Martínez JL, Cantón R. Antibiotics and antibiotic resistance in water environments. Current opinion in biotechnology. 2008 Jun 1;19(3):260-5.

Kourtis AP, Hatfield K, Baggs J, Mu Y, See I, Epson E, Nadle J, Kainer MA, Dumyati G, Petit S, Ray SM. Vital signs: epidemiology and recent trends in methicillin-resistant and in methicillin-susceptible Staphylococcus aureus bloodstream infections—United States. Morbidity and Mortality Weekly Report. 2019 Mar 3;68(9):214.

Lakhundi S, Zhang K. Methicillin-Resistant Staphylococcus aureus: Molecular Characterization, Evolution, and Epidemiology. Clin Microbiol Rev. 2018 Sep 12;31(4):e00020-18. doi: 10.1128/CMR.00020-18. PMID: 30209034; PMCID: PMC6148192.

Pantosti A, Venditti M. What is MRSA?. European Respiratory Journal. 2009 Nov 1;34(5):1190-6.

Martinez JL. General principles of antibiotic resistance in bacteria. Drug Discovery Today: Technologies. 2014 Mar 1;11:33-9.

Defres S, Marwick C, Nathwani D. MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia. European Respiratory Journal. 2009 Dec 1;34(6):1470-6.

Rogers RL, Perkins J. Skin and soft tissue infections. Primary Care: Clinics in Office Practice. 2006 Sep 1;33(3):697-710.

Spigelman M. MRSA--why treat the symptoms and not the disease?. Annals of the Royal College of Surgeons of England. 2005 Nov;87(6):452.

Brown NM, Goodman AL, Horner C, Jenkins A, Brown EM. Treatment of methicillin-resistant Staphylococcus aureus (MRSA): updated guidelines from the UK. JAC-Antimicrobial Resistance. 2021 Mar;3(1):dlaa114.

Lohan K, Sangwan J, Mane P, Lathwal S. Prevalence pattern of MRSA from a rural medical college of North India: A cause of concern. J Family Med Prim Care. 2021 Feb;10(2):752-757. doi: 10.4103/jfmpc.jfmpc_1527_20. Epub 2021 Feb 27. PMID: 34041072; PMCID: PMC8138351.

Lakhundi S, Zhang K. Methicillin-resistant Staphylococcus aureus: molecular characterization, evolution, and epidemiology. Clinical microbiology reviews. 2018 Oct;31(4):e00020-18.

Clay TB, Orwig KW, Stevens RA, Davis EP, Jennings II TM, Long TE, Riley BL, Hambuchen MD. Correlation of MRSA polymerase chain reaction (PCR) wound swab testing and wound cultures in skin and soft tissue infections. Diagnostic Microbiology and Infectious Disease. 2021 Aug 1;100(4):115389.

Amini M, Pourmand MR, Faridi-Majidi R, Heiat M, Mohammad Nezhady MA, Safari M, Noorbakhsh F, Baharifar H. Optimising effective parameters to improve performance quality in lateral flow immunoassay for detection of PBP2a in methicillin-resistant Staphylococcus aureus (MRSA). Journal of Experimental Nanoscience. 2020 Jan 1;15(1):266-79.

Zhang H, Ma L, Ma L, Hua MZ, Wang S, Lu X. Rapid detection of methicillin-resistant Staphylococcus aureus in pork using a nucleic acid-based lateral flow immunoassay. International journal of food microbiology. 2017 Feb 21;243:64-9.

Guk K, Keem JO, Hwang SG, Kim H, Kang T, Lim EK, Jung J. A facile, rapid and sensitive detection of MRSA using a CRISPR-mediated DNA FISH method, antibody-like dCas9/sgRNA complex. Biosensors and Bioelectronics. 2017 Sep 15;95:67-71

Cavassini M, Wenger A, Jaton K, Blanc DS, Bille J. Evaluation of MRSA-Screen, a simple anti-PBP 2a slide latex agglutination kit, for rapid detection of methicillin resistance in Staphylococcus aureus. Journal of Clinical Microbiology. 1999 May 1;37(5):1591-4.

Choo EJ, Chambers HF. Treatment of Methicillin-Resistant Staphylococcus aureus Bacteremia. Infect Chemother. 2016 Dec;48(4):267-273. doi: 10.3947/ic.2016.48.4.267. PMID: 28032484; PMCID: PMC5204005.

Clegg J, Soldaini E, McLoughlin RM, Rittenhouse S, Bagnoli F, Phogat S. Staphylococcus aureus vaccine research and development: The past, present and future, including novel therapeutic strategies. Frontiers in immunology. 2021 Jul 7;12:705360.

Nandhini P, Kumar P, Mickymaray S, Alothaim AS, Somasundaram J, Rajan M. Recent developments in Methicillin-Resistant Staphylococcus aureus (MRSA) treatment: a review. Antibiotics. 2022 Apr 29;11(5):606.

Dharmaratne P, Sapugahawatte DN, Wang B, Chan CL, Lau KM, Lau CB, Fung KP, Ng DK, Margaret IP. Contemporary approaches and future perspectives of antibacterial photodynamic therapy (aPDT) against methicillin-resistant Staphylococcus aureus (MRSA): A systematic review. European Journal of Medicinal Chemistry. 2020 Aug 15;200:112341.

Surwade P, Ghildyal C, Weikel C, Luxton T, Peloquin D, Fan X, Shah V. Augmented antibacterial activity of ampicillin with silver nanoparticles against methicillin-resistant Staphylococcus aureus (MRSA). The Journal of antibiotics. 2019 Jan;72(1):50-3.

Sikorska H, Smoragiewicz W. Role of probiotics in the prevention and treatment of meticillin-resistant Staphylococcus aureus infections. International journal of antimicrobial agents. 2013 Dec 1;42(6):475-81.

Aronoff GR, Sloan RS, Dinwiddie Jr CB, Glant MD, Fineberg NS, Luft FC. Effects of vancomycin on renal function in rats. Antimicrobial agents and chemotherapy. 1981 Feb;19(2):306-8.

Kostrominova TY, Hassett CA, Rader EP, Davis C, Larkin LM, Coleman S, Oleson FB, Faulkner JA. Characterization of skeletal muscle effects associated with daptomycin in rats. Muscle & nerve. 2010 Sep;42(3):385-93.

Gorchynski J, Rose JK. Complications of MRSA treatment: linezolid-induced myelosuppression presenting with pancytopenia. Western Journal of Emergency Medicine. 2008 Aug;9(3):177.

Wu PC, Wu CC. Tigecycline-associated hypofibrinogenemia: a case report and review of the literature. IDCases. 2018 Jan 1;11:56-7.

Borysowski J, Łobocka M, Międzybrodzki R, Weber-Dąbrowska B, Górski A. Potential of bacteriophages and their lysins in the treatment of MRSA: current status and future perspectives. BioDrugs. 2011 Dec;25:347-55.

Rubini D, Banu SF, Nisha P, Murugan R, Thamotharan S, Percino MJ, Subramani P, Nithyanand P. Essential oils from unexplored aromatic plants quench biofilm formation and virulence of Methicillin resistant Staphylococcus aureus. Microbial pathogenesis. 2018 Sep 1;122:162-73.

Zhang M, O’Donoghue MM, Ito T, Hiramatsu K, Boost MV. Prevalence of antiseptic-resistance genes in Staphylococcus aureus and coagulase-negative staphylococci colonising nurses and the general population in Hong Kong. Journal of hospital infection. 2011 Jun 1;78(2):113-7.