Methicillin-resistant Staphylococcus aureus is raising global concern as it overcomes immune challenges through various virulence mechanisms

Aswin Thacharodi; Saqib Hassan; Tawfeeq Ahmed; Gururaj Acharya; Nicole-Mae Geli Blacknell; Prabhakar Singh; Surajit Pal; A Saraswathi; Bhavana Rao Kosuru; Mohmmad Ashaq Sofi; Arivalagan Pugazhendhi

doi:10.1016/j.isci.2025.114376

Methicillin-resistant Staphylococcus aureus is raising global concern as it overcomes immune challenges through various virulence mechanisms

iScience. 2025 Dec 8;29(1):114376. doi: 10.1016/j.isci.2025.114376. eCollection 2026 Jan 16.

Authors

Affiliations

¹ Dr. Thacharodi's Laboratories, Department of Research and Development, Puducherry 605005, India.
² Department of Biotechnology, School of Bio and Chemical Engineering, Sathyabama Institute of Science and Technology, Chennai, Tamil Nadu 600119, India.
³ Future Leaders Mentoring Fellow, American Society for Microbiology, Washington, DC 20036, USA.
⁴ Department of Civil Engineering, NMAM Institute of Technology (NMAMIT), NITTE (Deemed to be University) , Udupi, Karnataka 574110, India.
⁵ Department of Biomedical Science, University of Sheffield, Sheffield, England.
⁶ Evolutionary Ecology and Genetics Research Group, Zoological Institute, Christian-Albrechts-Universität zu Kiel, Am Botanischen Garten 9, Kiel 24118, Germany.
⁷ Max Planck Fellow Group on Antibiotic Resistance Evolution, Max Planck Institute for Evolutionary Biology, August-Thienemann Str. 2, Plön 24306, Germany.
⁸ School of Biomolecular and Biomedical Sciences, University College Dublin, A94W890 Dublin, Ireland.
⁹ Department of Biomedical Engineering, Sathyabama Institute of Science and Technology, Deemed to be University, Chennai, Tamil Nadu 600119, India.
¹⁰ Institute of Research and Development, Duy Tan University, Da Nang, Vietnam.
¹¹ School of Engineering & Technology, Duy Tan University, Da Nang, Vietnam.

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) in the 21^st century remains a global concern with increasing rates of morbidity and mortality in healthcare settings. Hospital-associated MRSA strains have developed multidrug resistance (MDR), limiting the effectiveness of several commonly used antibiotics. First-line treatment for MRSA depends on the type of infection caused. Antibiotics such as vancomycin, linezolid, and daptomycin remain central to managing serious MRSA infections. However, the rise of MDR and the need to prevent further antibiotic resistance have led to the use of combinational antibiotic regimens to manage serious infections. Furthermore, MRSA can acquire virulence determinants and resistance plasmids via mobile genetic elements (MGEs) and stably inherit diverse resistance mechanisms, fostering hypervirulent MDR lineages that complicate clinical management. Together, these factors enable MRSA to evade host immune defences and cause serious infections with poor clinical outcomes. Collectively, this review highlights the epidemiological burden of MRSA with a better understanding of its resistance and virulence mechanisms and reinforces the need for optimized approaches to prevent, manage, and control infections.

Keywords: Disease; Medical microbiology; Public health.

Publication types

Review