Innovations in Biotechnology and Medical Sciences

Methicillin-Resistant Staphylococcus aureus (MRSA)

Note4Students

From UPSC perspective, the following things are important :

Prelims level: MRSA, Vancomycin

Why in the News?

In 2019, MRSA caused over 100,000 deaths, and although vancomycin has been the main treatment for 40 years, a new study shows it may not stay effective for long.

About Vancomycin

  • Vancomycin is an antibiotic that has been a cornerstone in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections for over 40 years.
  • It is a glycopeptide antibiotic that works by inhibiting the synthesis of bacterial cell walls, making it particularly effective against gram-positive bacteria like MRSA.
  • It has remained effective against MRSA due to its ability to target bacteria that have become resistant to other antibiotics like methicillin.
  • For decades, vancomycin has been the first-line treatment for severe MRSA infections, such as those affecting the bloodstream, heart, bones, and lungs.

How Vancomycin is losing its effectiveness against MRSA?

MRSA rarely develops resistance to vancomycin, but when it does, it leads to the emergence of vancomycin-resistant Staphylococcus aureus (VRSA).

  • Resistance Mechanism: When S. aureus acquires the vanA operon, a gene cluster responsible for vancomycin resistance, it can resist the antibiotic. However, this resistance usually comes with a fitness cost—the bacteria tend to grow slower, making them less virulent.
  • Fitness Compensation: Recent research shows that S. aureus can evolve to overcome this fitness cost, allowing VRSA to grow faster and remain resistant even in the absence of vancomycin. This adaptation means the bacteria are less likely to lose their resistance and can spread more easily.
  • Mutations: The study found that additional mutations in the VRSA strains exposed to vancomycin helped the bacteria adapt and maintain resistance. These mutations made the bacteria more fit, ensuring they could thrive even in the presence of vancomycin.
  • Diminishing Options: As VRSA continues to adapt, vancomycin may no longer be reliable for treating MRSA infections. This raises concerns about the long-term viability of the antibiotic, prompting the need for new treatment strategies.

PYQ:

[2014] Can overuse and free availability of antibiotics without Doctor’s prescription, be contributors to the emergence of drug-resistant diseases in India? What are the available mechanisms for monitoring and control? Critically discuss the various issues involved.

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