# data[].attributes.attachment_caption
Phylogenetic Tree of The Family Staphylococcaceae (Lory, 2014). 

# data[].attributes.body
Scientific name: Staphylococcus aureus.

Common names: staph, staph a., or golden staph.

Domain: Bacteria

Class: Bacilli

Family: Staphylococcaceae

Order: Bacillales

Phylum: Bacillota

# data[].attributes.body
Aliberti, Stefano & Reyes, Luis & Faverio, Paola & Sotgiu, Giovanni & Dore, Simone & Rodriguez, Alejandro & Soni, Nilam & Restrepo, Marcos & E.Morsy, Nesreen & Sobh, Eman & Cillóniz, Catia & Dalar, Levent. (2016). Global initiative for meticillin-resistant Staphylococcus aureus pneumonia (GLIMP): an international, observational cohort study (vol 16, 2016). The Lancet Infectious Diseases. 16. 1324-1324.

Cheung GYC, Bae JS, Otto M. Pathogenicity and virulence of Staphylococcus aureus. Virulence. 2021 Dec;12(1):547-569. doi: 10.1080/21505594.2021.1878688. PMID: 33522395; PMCID: PMC7872022.

Lory, S. (2014). The Family Staphylococcaceae . In: Rosenberg, E., DeLong, E.F., Lory, S., Stackebrandt, E., Thompson, F. (eds) The Prokaryotes. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-30120-9_350

M. Stegger, P.E. Akpaka, A. Alabi, S. Breurec, G. Coombs, B. Egyir, A.R. Larsen, F. Laurent, S. Monecke, G. Peters, R. Skov, B. Strommenger, F. Vandenesch, F. Schaumburg, & A. Mellmann, Origin, evolution, and global transmission of community-acquired Staphylococcus aureus ST8, Proc. Natl. Acad. Sci. U.S.A. 114 (49) E10596-E10604, https://doi.org/10.1073/pnas.1702472114 (2017).

Missiakas D and Winstel V (2021) Selective Host Cell Death by Staphylococcus aureus: A Strategy for Bacterial Persistence. Front. Immunol. 11:621733. doi: 10.3389/fimmu.2020.621733

Taylor TA, Unakal CG. Staphylococcus aureus Infection. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441868/

# data[].attributes.body
After a small hiking blister turned into months of recovering from a flesh-eating wound, I want to learn more about this pathogen that nearly cost me my foot and so many lives despite the advancement of our medical systems (infections are common in community-acquired and hospital-acquired settings).

# data[].attributes.body
Staphylococcus aureus is a gram-positive bacteria that does not normally cause infection on healthy skin; however, if allowed to enter the internal tissues or bloodstream, these bacteria can cause various potentially life-threatening infections.

# data[].attributes.body
In 1880 in Scotland by the surgeon Sir Alexander Ogston, who detected "micrococci" when viewing pus drained from infected knee joint abscesses under a microscope.

# data[].attributes.headline
What was the suspected infectious agent?

# data[].attributes.subject
What was the suspected infectious agent?

# data[].attributes.body
Ogston first described staphylococci as bacteria “masses [that] looked like bunches of grapes,” as the causative agent some infections. In 1884, German physician Friedrich Julius Rosenbach differentiated the bacteria into S. aureus and S. albus.

S. aureus infections can spread through contact with an infected wound, skin-to-skin contact with an infected person, and contact with objects used by an infected person.

# data[].attributes.body
A bacterial infection disease: an illness caused by the presence and multiplication of harmful bacteria within the body.

# data[].attributes.body
The ancestor of all S. aureus most likely emerged in Central Europe in the mid-19th century. From here, it was exported to North America in the early 20th century and then globally, including Africa. Now, S. aureus has a worldwide distribution and is found in all of Europe, the Americas, North Africa, the Middle and Far East, and Asia-Pacific (Stegger, 2017).

# data[].attributes.body
S. aureus has a rapid mutation rate. Considerable scientific effort has been invested over the decades to track strains of S. aureus over spatial and temporal scales; however, these routes still remain not well understood to date.

# data[].attributes.body
Approximately 30% of the human population is colonised with S. aureus, often without any illness.

S. aureus infections have a mortality rate of 10-30% and an estimated incidence of 4.3-38.2 per 100,000 person-years in North America.

In 2017, there were 50,000 deaths linked to staphylococcal infection in America.

# data[].attributes.headline
11/04 Virulence: the degree to which a pathogen harms its host (usually measured as a reduction in host fitness).

# data[].attributes.subject
11/04 Virulence: the degree to which a pathogen harms its host (usually measured as a reduction in host fitness).

# data[].attributes.body
S. aureus can be considered highly virulent, leading to severe infections, including furuncles, abscesses, and wound infections. Considering the prevalence of antibiotic-resistant strains, it can commonly be fatal. It has been noted to account for a greater number of deaths than that caused by acquired immune deficiency syndrome (AIDS), tuberculosis, and viral hepatitis combined.

Its virulence is aided by its ability to produce an array of virulence factors, including toxins, immune evasion factors, and protein factors, that enable host colonisation during infection. Further, S. aureus has a high degree of genetic plasticity, allowing it to acquire new virulence factors, including those that mediate antibiotic resistance, contributing to its evolving capabilities.

In 1941, penicillin was introduced as a successful treatment for S. aureus infections, but resistance emerged rapidly. The first naturally occurring penicillin-resistant S. aureus was noted in 1942, and by the end of the decade, almost all S. aureus infections were penicillin-resistant.

Meticillin was developed in response and introduced in 1959. Professor Patricia Jevons discovered resistance to meticillin in 1960, and by 1997, meticillin-resistant S. aureus (MRSA) accounted for 50% of hospital S. aureus infections.

MRSA continues to evolve in an arms race against medicine and is endemic in our hospitals and the community. It is often multi-drug resistant, leaving little treatment options and contributing to its high mortality rate.

(Cheung, 2021)

# data[].attributes.body
The treatment of S. aureus has evolved with the pathogen in a mutation-arms-race.

Before the discovery of penicillin, treatment options were limited to topical applications of carbolic acid or other toxic chemicals. Much of the research at the time focused on developing a vaccine.

The discovery of the antibiotic, penicillin, proved effective, but resistance emerged quickly, leading to the antibiotic methicillin. However, S. aureus adapted again, becoming methicillin-resistant (MRSA).

Current treatment options include the glycopeptide antibiotic vancomycin.

Other antibiotics like daptomycin and linezolid, as well as newer agents like telavancin and ceftaroline, are also used to treat S. aureus infections, including MRSA. In the case of severe infection, combination antibiotics may be used to combat population-level mutations.

Infection control measures, such as handwashing and isolation protocols, remain crucial. So does wound care, including drainage of pus and removal of infected tissue.

# data[].attributes.body
Prevention and surveillance are key to combating S. aureus.

Active surveillance programs screen for MRSA colonisation, allowing for early detection and implementation of contact precautions. This has also promoted collaboration between healthcare professionals, institutions and departments to track and prevent the spread of resistant strains. Furthermore, hospitals and clinics are implementing antimicrobial stewardship programs to promote judicious use of antibiotics, preventing the development of further resistance.

# data[].attributes.body
S. aureus's ability to develop drug resistance has driven significant advancements in medical treatments, including the development of new antibiotics, diagnostic tools (molecular assays and PCR), and alternative therapeutic strategies to combat resistant strains (antimicrobial peptides and biofilm disrupters).

Several new technologies are emerging to combat S. aureus and address the threat of antibiotic resistance. Researchers are investigating the use of sugar carriers to transport antibiotics into bacteria, potentially enhancing their effectiveness. Alternatively, other mechanisms for killing the S. aureus include bacteriophage therapy (viruses that infect and kill bacteria). This is explored alongside novel vaccines that can protect against both colonisation and invasive S. aureus infections.

Alongside the development of treatment options, prevention remains a primary objective, so new diagnostic tools, such as micropore technology combined with machine learning, are being developed to improve the accuracy and speed of S. aureus identification. Advanced photohydrolysis technology is also being used to reduce contamination of surfaces and air in healthcare settings.

# data[].attributes.body
Initial Identification and Early Response
At the time, no specific governmental response existed for individual pathogens—public health was more broadly focused on sanitation and general infection control.

The appearance of penicillin-resistant strains prompted early hospital infection control policies, but there was no governmental involvement.

MRSA Emergence and Public Health Policy (1960s onward).

As MRSA spread in hospitals globally, governments and hospital leadership began developing stricter infection control practices, including institutionalising hand hygiene protocols, sterilisation guidelines, and patient isolation procedures.

In 1980, the CDC (U.S.) response included MRSA surveillance and prevention in their National Nosocomial Infections Surveillance System (NNIS), while the

the UK’s NHS implemented mandatory MRSA screening for surgical patients in 2000 and published annual hospital infection rates.

Current-Day Handling

Governmental bodies like the CDC, ECDC (European Centre for Disease Prevention and Control), and WHO track MRSA infections through public health surveillance programs.

Governments now promote judicious use of antibiotics in both human and veterinary medicine to prevent resistance. These are called Antibiotic Stewardship Programs.

In hospitals, there is mandatory screening of high-risk patients, use of personal protective equipment, and strict use of environmental cleaning and disinfectant. Further, there is a much greater public awareness through campaigns on hygiene and resistance.

Many countries fund research into new antibiotics, vaccines, and alternative therapies like bacteriophages due to the rise of multidrug-resistant strains.

Finally, there is a global action plan
headed by WHO, initiated in 2015, directly addresses S. aureus and other resistant bacteria, urging member states to improve awareness and surveillance, reduce the incidence of infection, optimise antimicrobial use and invest in research.

# data[].attributes.headline
Innovation of Initiatives to Combat S. aureus 25/04

# data[].attributes.subject
Innovation of Initiatives to Combat S. aureus 25/04

# data[].attributes.body
One of the most significant innovations has been a by-product of the devastation caused by MRSA - the implementation of Antibiotic Stewardship Programs. These programs are designed to promote the appropriate use of antibiotics in order to slow the development of resistance. By using data analytics and electronic medical record systems, stewardship teams—composed of pharmacists, infectious disease specialists, and microbiologists—can monitor antibiotic prescribing patterns and intervene when inappropriate prescriptions are made.

Another key innovation has been the development of rapid diagnostic tools to detect S. aureus and differentiate between MRSA strains.

Infection control within healthcare settings has also seen technological and procedural innovation. One example is using ultraviolet (UV) light and hydrogen peroxide vapour systems to decontaminate hospital rooms and equipment.

From a research and pharmaceutical standpoint, efforts have to extend beyond traditional antibiotics in case they fail. Scientists are exploring bacteriophage therapy, which uses viruses that specifically target and kill bacteria like S. aureus, including resistant strains. Moreover, researchers have been investigating anti-virulence therapies.

# data[].attributes.headline
What could leadership have done better in response to this disease? 25/04

# data[].attributes.subject
What could leadership have done better in response to this disease? 25/04

# data[].attributes.body
One of the most notable failings was the initial underestimation of antibiotic resistance. When penicillin resistance first appeared in S. aureus in the 1940s, and later when methicillin resistance emerged in the 1960s, the problem was primarily viewed as a clinical curiosity rather than a public health emergency. This delayed the implementation of coordinated infection control and surveillance measures, allowing resistant strains to spread more widely within hospitals.

Another area where leadership failed to regulate was the overuse and unregulated distribution of antibiotics in healthcare and agriculture. For many years, antibiotics were prescribed too liberally, often for viral infections where they were ineffective, contributing to environmental reservoirs of resistant bacteria.

Additionally, there were failings in public health communication. For a long time, MRSA and S. aureus were perceived as primarily hospital-related issues, which left the public underinformed about the risks of community-acquired infections. As MRSA began to emerge in schools, athletic facilities, and other community settings in the early 2000s, the lack of public awareness led to fear, stigma, and misinformation.

# data[].attributes.headline
Societal and sociological impact of this disease. 27/04

# data[].attributes.subject
Societal and sociological impact of this disease. 27/04

# data[].attributes.body
S. aureus heightened public fear of healthcare-associated infections and eroded trust in hospital environments that were once seen as places of healing. The emergence of community-acquired MRSA also shifted the perception that serious bacterial infections were confined to healthcare settings, leading to anxiety in schools, gyms, and workplaces. Sociologically, the disease highlighted inequalities, as vulnerable groups (such as the elderly, immunocompromised individuals, and low-income communities) were disproportionately affected, emphasizing systemic gaps in healthcare access, hygiene standards, and education around infection prevention.

# data[].attributes.body
On a broad scale, hygiene became a much more widespread concern. Not only did hospitals introduce stricter infection control policies, such as mandatory hand hygiene, screening protocols, isolation procedures, but so did many community institutions. For example, athletic facilities and schools increased sanitation efforts, encouraging people to disinfect shared equipment and cover skin abrasions. Further, public awareness campaigns promoted more rigorous personal hygiene habits, like frequent handwashing and careful wound care. These changes reflected a shift toward collective responsibility for infection prevention, extending infection control from clinical settings into everyday community life.

# data[].attributes.headline
Has society “learned” from the physical effect of S. aureus? 27/04

# data[].attributes.subject
Has society “learned” from the physical effect of S. aureus? 27/04

# data[].attributes.body
The spread of MRSA reinforced the importance of responsible antibiotic use, leading to stronger regulations around antibiotic prescriptions and agricultural antibiotic use. It became a case study in public health education, teaching the lasting lesson that infectious diseases evolve alongside human behavior, and proactive, coordinated responses are necessary to prevent widespread outbreaks.