New trends in Staphylococcus aureus infections: glycopeptide resistance in hospital and methicillin resistance in the community

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Abstract
Methicillin-resistant Staphylococcus aureus is prevalent in hospitals throughout the world, and we have got used to its presence in daily clinical practice. However, methicillin-resistant S. aureus has not remained static over the past four decades, but seems to be evolving in unfamiliar directions. This review focuses on recent findings on two directions of methicillin-resistant S. aureus evolution: the acquisition of multiple antibiotic resistance in the hospital and the trend towards methicillin-resistant S. aureus as a community pathogen. We looked at reports on glycopeptide resistance in S. aureus and those on community-acquired methicillin-resistant S. aureus strains, with some references of historical value to explain the entire picture of this ‘new field’ of the methicillin-resistant S. aureus problem. The references given here (excluding some of low credibility) attest the increasing awareness of the two conspicuous problems concerning methicillin-resistant S. aureus infection. One is the increasing trend of glycopeptide-resistance, making difficult the successful treatment of multi-drug-resistant methicillin-resistant S. aureus infection in the hospital. On the other hand, non-multi-drug-resistant methicillin-resistant S. aureus strains are emerging as novel threats in the community, the genetic analysis of which indicates that they are independent clones from those found in hospitals.