Preface

**Section 4 Detection of Staphylococcus aureus 133**

**VI** Contents

Xiaoxiao Wu and Chi Zhang

**Lettuce (Lactuca sativa) 145**

Irma Isnafia Arief

**Animal Models 179**

Piotr Szweda and Barbara Kot

Chapter 6 **Determination of Staphylococcal Phenol-Soluble Modulins (PSMs) by a High-Resolution HPLC-QTOF System 135**

Chapter 7 **PCR Assay for Detection of Staphylococcus aureus in Fresh**

**Section 5 Prevention and Treatment of Staphylococcus aureus 165**

Chapter 8 **Prevention of Staphylococcus aureus Contamination on Animal Products Using Indonesian Natural Products 167**

Chapter 9 **Bacteriophage Therapy: An Alternative for the Treatment of Staphylococcus aureus Infections in Animals and**

Marcos Cajero-Juárez and Juan J. Valdez-Alarcón

Chapter 10 **Bee Products and Essential Oils as Alternative Agents for Treatment of Infections Caused by S. aureus 203**

Claudia I. Barrera-Rivas, Norma A. Valle-Hurtado, Graciela M. González-Lugo, Víctor M. Baizabal-Aguirre, Alejandro Bravo-Patiño,

Andrés F. Chávez‐Almanza, Jaime López‐Cervantes, Ernesto U. Cantú‐Soto, Dalia I. Sánchez‐Machado and Olga N. Campas‐Baypoli

*Staphylococcus aureus* is a beautiful golden bacterium that haunts epithelial surfaces of the human body, patiently awaiting the opportunity to invade and infect even the healthiest individuals. What makes it successful as a human pathogen? How has it developed antibiot‐ ic resistance so rapidly? And, how has it been able to spread across the world so swiftly? Here, multiple experts examine this golden toxin-producing Gram-positive organism and provide insight into what genotypic and phenotypic shifts have occurred in *S. aureus* over the past 100 years to make it the superbug it is today.

There were several underlying reasons why we wrote this book. Firstly, rates of significant *S. aureus* clinical infections have continued to climb. Secondly, defining various modes of *S. aureus* transmission may lead to improved prevention and increased recognition of *S. aureus* infections. Thirdly, the need for discovering new ways to rapidly detect this aggressive or‐ ganism has become an urgent issue.

Through the chapters within, the authors examine patterns of colonization and exposures in humans, mammals, and birds that have led to the development of antibiotic resistance, in‐ cluding methicillin-resistant *S. aureus* (MRSA). Alternative, novel chemotherapeutics to tar‐ get *S. aureus* are discussed, including herbal medicines, bee products, and modes of delivery, as conventional antibiotic options to treat this aggressive, multifaceted, and readily adaptable pathogen are becoming limited. This book is an excellent starting point for any‐ one who wants or needs to study *S. aureus*. Most of the chapters are oriented toward the detection and prevention of *S. aureus* and research for unconventional treatment of patients infected with these bacteria, and importantly, we include several review chapters to allow scientists and clinicians to better understand the epidemiology, transmission, and clinical significance of these golden bacteria.

We believe that our "Frontiers in *Staphylococcus aureus"* is an excellent book for microbiolo‐ gists, especially those who are interested in this superbug. We hope you enjoy reading it. Finally, we would like to thank all the contributing authors who contributed a great deal of time and original research to this project.

> **Dr. Shymaa Enany** Department of Microbiology and Immunology, Faculty of Pharmacy Suez Canal University, Ismailia, Egypt

> > **Dr. Laura E. Crotty Alexander** Department of Medicine, University of California, San Diego, and VA San Diego Healthcare System, San Diego, CA, USA

**Staphylococcus aureus Overview**

#### *Staphylococcus aureus***: Overview of Bacteriology, Clinical Diseases, Epidemiology, Antibiotic Resistance and Therapeutic Approach** *Staphylococcus aureus***: Overview of Bacteriology, Clinical Diseases, Epidemiology, Antibiotic Resistance and Therapeutic Approach**

Arumugam Gnanamani, Periasamy Hariharan and Maneesh Paul-Satyaseela Hariharan and Maneesh Paul-Satyaseela Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

Arumugam Gnanamani, Periasamy

http://dx.doi.org/10.5772/67338

#### **Abstract**

*Staphylococcus aureus* is an important human pathogen that causes wide range of infectious conditions both in nosocomial and community settings. The Gram-positive pathogen is armed with battery of virulence factors that facilitate to establish infections in the hosts. The organism is well known for its ability to acquire resistance to various antibiotic classes. The emergence and spread of methicillin-resistant *S. aureus* (MRSA) strains which are often multi-drug resistant in hospitals and subsequently in community resulted in significant mortality and morbidity. The epidemiology of MRSA has been evolving since its initial outbreak which necessitates a comprehensive medical approach to tackle this pathogen. Vancomycin has been the drug of choice for years but its utility was challenged by the emergence of resistance. In the last 10 years or so, newer anti-MRSA antibiotics were approved for clinical use. However, being notorious for developing antibiotic resistance, there is a continuous need for exploring novel anti-MRSA agents from various sources including plants and evaluation of non-antibiotic approaches.

**Keywords:** *Staphylococcus aureus*, MRSA, CA-MRSA, HA-MRSA, anti-MRSA

#### **1. Introduction**

*Staphylococcus aureus* is a Gram-positive bacterium and causative agent of wide range of infectious diseases such as skin infections, bacteremia, endocarditis, pneumonia and food poisoning. The organism was originally a leading nosocomial pathogen and afterwards epidemiologically distinct clones emerged in community settings. *S. aureus* expresses number

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

of virulence factors which help to establish infection by facilitating tissue attachment, tissue invasion and evading from host immune response. The ability to acquire resistance to multiple antibiotics classes makes *S. aureus*, a challenging pathogen to treat. Emergence and spread of *S. aureus* strains which are resistant to methicillin, referred to as methicillin-resistant *S. aureus* (MRSA) resulted in high morbidity, high mortality and increased treatment costs. Vancomycin remained gold standard drug to tackle these strains for years but the emergence of resistance restricted its clinical utility. Newer anti-MRSA antibiotics which were approved by U.S. FDA came as respite for clinicians. However, new antibiotic discovery efforts and non- antibiotic approaches to tackle MRSA should not be diminished considering the ability of the pathogen to acquire resistance to newer drugs quickly after their introduction in clinics.

In this chapter, we present a comprehensive outlook of *S. aureus* with account on bacteriology, pathogenesis, epidemiology, antibiotic resistance and therapeutic approaches.
