Evidence map›Paper›PMID 22522561›Full record

ArticleNature medicine2012

MRSA epidemic linked to a quickly spreading colonization and virulence determinant.

Min Li, Xin Du, Amer E Villaruz, Binh An Diep, Decheng Wang, Yan Song, Yueru Tian, Jinhui Hu, Fangyou Yu, Yuan Lu and 1 more

Abstract read
In one paragraph

Article in Nature medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 141 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
141citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

141 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
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  12. Cell surface (Amsterdam, Netherlands) · 2025
    Review
  13. Article
  14. Article
  15. Distribution ofFrontiers in cellular and infection microbiology · 2025
    Article
  16. Article
  17. Multidrug-ResistantInfection and drug resistance · 2025
    Article
  18. Sequencing a CC239-MRSA-III with a novel composite SCC mec element from Kuwait.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024
    Article
  19. Article
  20. Review

81 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Min LiDepartment of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, China.
Xin Du
Amer E Villaruz
Binh An Diep
Decheng Wang
Yan Song
Yueru Tian
Jinhui Hu
Fangyou Yu
Yuan Lu
Michael Otto

Funding

Staphylococcal pathogenesisZIAAI000904 · NIAID · NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES · PI OTTO, MICHAEL · 2009 to 2025
$22.6M
Role of the human microbiota and probioticsZIAAI001080 · NIAID · NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES · PI OTTO, MICHAEL · 2009 to 2025
$9.7M
Intramural NIH HHS ZIA AI000904
6 · The paper itself

Abstract

The molecular processes underlying epidemic waves of methicillin-resistant Staphylococcus aureus (MRSA) infection are poorly understood(1). Although a major role has been attributed to the acquisition of virulence determinants by horizontal gene transfer(2), there are insufficient epidemiological and functional data supporting that concept. We here report the spread of clones containing a previously extremely rare(3,4) mobile genetic element–encoded gene, sasX. We demonstrate that sasX has a key role in MRSA colonization and pathogenesis, substantially enhancing nasal colonization, lung disease and abscess formation and promoting mechanisms of immune evasion. Moreover, we observed the recent spread of sasX from sequence type 239 (ST239) to invasive clones belonging to other sequence types. Our study identifies sasX as a quickly spreading crucial determinant of MRSA pathogenic success and a promising target for therapeutic interference. Our results provide proof of principle that horizontal gene transfer of key virulence determinants drives MRSA epidemic waves.

Indexed as

AnimalsChinaFemaleHumansMethicillin-Resistant Staphylococcus aureusMiceMice, HairlessMice, Inbred ICRVirulence

Identifiers

PMID22522561
PMCPMC3378817

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.