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How one strain of MRSA becomes resistant to last-line antibiotic

Researchers have uncovered what makes one particular strain of methicillin-resistant Staphylococcus aureus (MRSA) so proficient at picking up resistance genes, such as the one that makes it resistant to vancomycin, the last line of defense for hospital-acquired infections. They report their findings in mBio, the online open-access journal of the American Society for Microbiology, on Tuesday May 22.

"MRSA strains are leading causes of hospital-acquired infections in the United States, and clonal cluster 5 (CC5) is the predominant lineage responsible for these infections. Since 2002, there have been 12 cases of vancomycin-resistant S. aureus (VRSA) infection in the United States—all CC5 strains," write the researchers from Harvard, the Massachusetts Eye and Ear Infirmary in Boston and the Broad Institute in Cambridge and other institutions. "Vancomycin is a key last-line bactericidal drug for treating these infections."

The CC5 strain of MRSA has managed to acquire resistance to vancomycin on 12 separate occasions, and although it hasn't spread widely yet, the risk that MRSA could eventually overwhelm even our last-line drugs is a very serious one. In the study, the researchers sequenced the genomes of all available vancomycin-resistant MRSA strains to find what distinguishes them from other lineages and why CC5 is apparently more adept than other strains at picking up vancomycin resistance.

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