Is methicillin-resistant Staphylococcus aureus replacing methicillin-susceptible S. aureus?

J Antimicrob Chemother. 2011 Oct;66(10):2199-214. doi: 10.1093/jac/dkr278. Epub 2011 Jul 7.


Despite extensive research on the emergence of and treatments for methicillin-resistant Staphylococcus aureus (MRSA), prior studies have not rigorously evaluated the impact of methicillin resistance on the overall incidence of S. aureus infections. Yet, there are direct clinical and research implications of determining whether methicillin-susceptible S. aureus (MSSA) infection rates remain stable in the face of increasing MRSA prevalence or whether MSSA will be replaced over time. A synthesis of prior studies indicates that the emergence of healthcare-associated MRSA (HA-MRSA) and community-associated MRSA (CA-MRSA) has led to an increase in the overall incidence of S. aureus infections, with MRSA principally adding to, rather than replacing, MSSA. However, colonization with CA-MRSA may at least partially replace colonization with MSSA. So far, evidence indicates that MSSA still accounts for many infections. Therefore, eradication of MRSA alone is not sufficient to address the public health burden of S. aureus.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / microbiology
  • Drug Resistance, Microbial
  • Humans
  • Methicillin / pharmacology
  • Methicillin Resistance
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • Public Health
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology*
  • Staphylococcus aureus / drug effects*


  • Methicillin