Methicillin-Resistant Staphylococcus aureus: An Evolutionary, Epidemiologic, and Therapeutic Odyssey

Abstract

It was only 1 year after an Oxfordshire constable, Albert Alexander, became the first recipient of penicillin, that Rammelkamp reported the identification of isolates of Staphylococcus aureus resistant to this miracle drug [1]. Infections caused by penicillin-resistant S. aureus were initially limited to hospitalized patients and were only later detected in the community, where they eventually became common [2]. In an historical reprise, the identification of methicillin-resistant S. aureus (MRSA) was reported within 1 year after the 1960 introduction of this semisynthetic penicillin, and once again, an organism that was initially present only in hospitals later became prevalent in the community [2, 3]. The spread of MRSA from the hospital to the community was a predictable event. The emergence in the past decade of novel strains of MRSA in the community that are genetically distinct from MRSA strains originating in the hospital was perhaps less anticipated.