Staphylococcus aureus colonization and infection: optimizing MRSA decolonization and addressing challenges in S. aureus bacteremia management

Abstract

As a human commensal, Staphylococcus aureus colonizes more than half of the population. Colonized persons are often asymptomatic and can be colonized in the anterior nares, throat, groin, and other body sites. In only a minority, S. aureus causes disease - ranging from common and relatively benign infections such as folliculitis to severe invasive infections such as endocarditis, spondylodiscitis, and bacteremia. S. aureus is the leading cause of mortality by bloodstream infections worldwide. A major additional complicating factor is the capacity of S. aureus to develop antimicrobial resistance. Colonization with methicillin-resistant S. aureus (MRSA) increases infection risk even more than its susceptible counterpart. MRSA is currently the leading cause of mortality attributable to antimicrobial resistance in the world.

Despite the high prevalence and global burden of S. aureus, many questions remain unanswered with respect to the management and risk factors of both colonization and invasive infection. Research is continuously ongoing in order to unravel the complexities of this extraordinary pathogen and the diseases it causes in humans. This thesis aims to address the optimization of MRSA decolonization and some of the frequently encountered challenges in S. aureus bacteremia management.