Methicillin-resistant Staphylococcus aureus at the cross roads: past lessons, present challenges, and future directions

Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a challenging pathogen in clinical settings with the infections varying from superficial skin infection to severe manifestations like bacteraemia, osteomyelitis, and infective endocarditis. MRSA, discovered in 1961, is a well known global health concern for its phenomenal ability to acquire resistance. Specifically, the mec A gene expressing penicillin-binding protein 2a (PBP2a) imparts resistance to β-lactam antibiotics. This review will present a comprehensive summary of MRSA, focusing on its historical evolution, pathogenesis, resistance, diagnostic options, treatment, and prophylaxis. An effort is made to compare ordinary end-phenotyping and genotype diagnostic approach, emphasizing their pros and cons in common laboratories. This article highlights the importance of early identification, targeted antimicrobial stewardship, and effective infection control efforts to limit the transmission of MRSA and to optimize patient outcomes in the healthcare and community settings.