ArticleGenome biology2017
Methicillin-resistant Staphylococcus aureus emerged long before the introduction of methicillin into clinical practice.
Article in Genome biology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 132 papers, 2 of them syntheses that pooled it.
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132 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Current State of Knowledge Regarding WHO High Priority Pathogens-Resistance Mechanisms and Proposed Solutions through Candidates Such as Essential Oils: A Systematic Review.International journal of molecular sciences · 2023Pooled it
- Methicillin-ResistantToxins · 2020Pooled it
- Methicillin-resistant Staphylococcus aureus.Nature reviews. Disease primers · 2026Review
- Antimicrobial Resistance in Major Gram-Positive Pathogens: Beyond the Vancomycin Border.Antibiotics (Basel, Switzerland) · 2026Review
- Multi-drug resistant Staphylococcus aureus from Bovine Mastitis: epidemiological and molecular insights from Central Ethiopia.BMC veterinary research · 2026Article
- Molecular diagnosis of methicillin-resistantOpen veterinary journal · 2026Article
- DksA inhibitors against intracellular and persistentScience advances · 2026Article
- Antimicrobial peptides-based strategies at the frontline in battling the escalating menace of methicillin-resistant Staphylococcus aureus biofilms.European journal of microbiology & immunology · 2026Review
- Prevalence, Antimicrobial Resistance Profiles, and Molecular Characteristics of Methicillin-ResistantPathogens (Basel, Switzerland) · 2026Article
- The Brief Case: Adjudication of discrepant genotypic and phenotypic antimicrobial susceptibility testing results in a patient withJournal of clinical microbiology · 2026Review
- StaphScope: a species-optimized computational pipeline for rapid and accessible Staphylococcus aureus genotyping and surveillance.BMC genomics · 2026Article
- Methicillin-resistant and susceptible Staphylococcus aureus: tolerance, immune evasion and treatment.Nature reviews. Microbiology · 2026Review
- The clinical utility of nasal MRSA PCR as an antimicrobial stewardship tool to guide MRSA bacteraemia therapy in paediatrics: a retrospective study at a tertiary care centre.JAC-antimicrobial resistance · 2026Article
- Evolution and rise of antimicrobial resistance in key public health bacteria within and across the One Health sectors.Future microbiology · 2026Review
- Methicillin-resistantiScience · 2026Review
- Molecular Diversity and Comparison of Staphylococcal Cassette ChromosomeInternational journal of microbiology · 2026Article
- A comprehensive review of emerging therapeutic strategies against methicillin-resistantFrontiers in microbiology · 2026Review
- Network analysis of antimicrobial resistance inNAR genomics and bioinformatics · 2025Article
- An antimicrobial peptide as a potential therapy for bacterial pneumonia that alleviates antimicrobial resistance.Nature communications · 2025Article
- Selective Targeting and Enhanced Photodynamic Inactivation of Methicillin-ResistantAntibiotics (Basel, Switzerland) · 2025Article
72 more citing papers are in PubMed but not listed here.
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Abstract
backgroundThe spread of drug-resistant bacterial pathogens poses a major threat to global health. It is widely recognised that the widespread use of antibiotics has generated selective pressures that have driven the emergence of resistant strains. Methicillin-resistant Staphylococcus aureus (MRSA) was first observed in 1960, less than one year after the introduction of this second generation beta-lactam antibiotic into clinical practice. Epidemiological evidence has always suggested that resistance arose around this period, when the mecA gene encoding methicillin resistance carried on an SCCmec element, was horizontally transferred to an intrinsically sensitive strain of S. aureus.
resultsWhole genome sequencing a collection of the first MRSA isolates allows us to reconstruct the evolutionary history of the archetypal MRSA. We apply Bayesian phylogenetic reconstruction to infer the time point at which this early MRSA lineage arose and when SCCmec was acquired. MRSA emerged in the mid-1940s, following the acquisition of an ancestral type I SCCmec element, some 14 years before the first therapeutic use of methicillin.
conclusionsMethicillin use was not the original driving factor in the evolution of MRSA as previously thought. Rather it was the widespread use of first generation beta-lactams such as penicillin in the years prior to the introduction of methicillin, which selected for S. aureus strains carrying the mecA determinant. Crucially this highlights how new drugs, introduced to circumvent known resistance mechanisms, can be rendered ineffective by unrecognised adaptations in the bacterial population due to the historic selective landscape created by the widespread use of other antibiotics.
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