Multiple Roles of Staphylococcus aureus Enterotoxins: Pathogenicity, Superantigenic Activity, and

Correlation to Antibiotic Resistance

Heat-stable enterotoxins are the most notable virulence factors associated with Staphylococcus aureus,
a common pathogen associated with serious community and hospital acquired diseases. Staphylococcal
enterotoxins (SEs) cause toxic shock-like syndromes and have been implicated in food poisoning. But SEs
also act as superantigens that stimulate T-cell proliferation, and a high correlation between these
activities has been detected. Most of the nosocomial S. aureus infections are caused by methicillin-
resistant S. aureus (MRSA) strains, and those resistant to quinolones or multiresistant to other
antibiotics are emerging, leaving a limited choice for their control. This review focuses on these diverse
roles of SE, their possible correlations and the influence in disease progression and therapy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153285/

Prevalence of Toxin Genes among the Clinical Isolates of Staphylococcus aureus and its Clinical Impact

Staphylococcus aureus (S. aureus) causes a variety of infections, ranging from a mild skin infection to
blood stream infections and deep seated infections. As Stapylococcus aureus bacteremia (SAB) has the
tendency to cause endovascular and metastatic infections, complications can occur at almost all sites of
the body. Hence, SAB is associated with increased morbidity and mortality in spite of appropriate
antimicrobial treatment. The virulence in S. aureus is determined by the presence of adhesins and
toxins, which behave like superantigens (SAgs) and leads to a massive release of proinflammatory
cytokines causing overwhelming inflammatory response leading to endothelial leakage, hemodynamic
shock, multiorgan failure, and possibly death

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4557147/

Reductions in Workload and Reporting Time by Use of Methicillin-Resistant Staphylococcus

aureus Screening with MRSASelect Medium Compared to Mannitol-Salt Medium Supplemented with
Oxacillin

Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen in both nosocomial and

community settings, and screening for carriers is an important infection control practice in many
hospitals. In this retrospective study, we demonstrate that the implementation of an MRSA screening
protocol using a selective chromogenic medium (MRSASelect) reduced the workload for this screening
test by 63.7% overall and by 12.6% per specimen and reduced the turnaround time for reporting by an
average of 1.33 days for all MRSA screening specimens, 1.97 days for MRSA-positive specimens, and 1.3
days for MRSA-negative specimens compared to standard mannitol-salt agar supplemented with 6 mg of
oxacillin/liter.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292897/
Assessment of the suitability of mannitol salt agar for growing bovine-associated coagulase-negative
staphylococci and its use under field conditions.

This study aimed at testing the applicability of mannitol salt agar (MSA), a medium generally used in
human medicine for differentiating Staphylococcus aureus from coagulase-negative staphylococci (CNS),
for culturing bovine-associated CNS species. All test isolates from a comprehensive collection of well-
identified CNS species, including both reference strains and field isolates, were able to grow.
Subsequently, bulk milk samples and teat apex swabs were used to examine the capability of MSA for
yielding CNS under field conditions. Sixty-nine and 47 phenotypically different colonies were retrieved
from bulk milk and teat apices, respectively. The majority of isolates from teat apices were
staphylococci, whereas in bulk milk, staphylococci formed a minority. After 24h of growth, recovery of
separate colonies of CNS was much more convenient on MSA compared to a non-selective blood agar.
The results of this study indicate that MSA is a suitable medium for both growth and recovery of bovine-
associated CNS.

https://www.ncbi.nlm.nih.gov/pubmed/23809647/

Staphylococcus aureus bacteremia: epidemiology, pathophysiology, and management strategies.

Staphylococcus aureus is a major cause of bacteremia, and S. aureus bacteremia is associated with
higher morbidity and mortality, compared with bacteremia caused by other pathogens. The burden of S.
aureus bacteremia, particularly methicillin-resistant S. aureus bacteremia, in terms of cost and resource
use is high. The risk of infective endocarditis and of seeding to other metastatic foci increases the risk of
mortality and raises the stakes for early, appropriate treatment. The incidence of S. aureus bacteremia
and its complications has increased sharply in recent years because of the increased frequency of
invasive procedures, increased numbers of immunocompromised patients, and increased resistance of
S. aureus strains to available antibiotics. This changing epidemiology of S. aureus bacteremia, in
combination with the inherent virulence of the pathogen, is driving an urgent need for improved
strategies and better antibiotics to prevent and treat S. aureus bacteremia and its complications.

https://www.ncbi.nlm.nih.gov/pubmed/19374578/