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      Impact of MRSA on the military medical service and diagnostic point-of-care options for the field setting

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          Abstract

          Methicillin-resistant Staphylococcus aureus (MRSA) poses an infection risk for international military deployments. In the presented mini-review, the history of MRSA in the medical service and modern warfare is highlighted. To allow rapid diagnosis, various molecular diagnostic point-of-care solutions are available. Most evaluation studies, however, are focused on screening swabs rather than clinical materials and evaluation data from harsh environments are widely lacking. Accordingly, studies with complex sample materials under difficult environmental conditions, e.g., in the desert or in the tropics, are desirable to close this gap of knowledge regarding the diagnostic reliability of such modern molecular point-of-care devices.

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          Most cited references28

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          Staphylococcus aureus α-Toxin: Nearly a Century of Intrigue

          Staphylococcus aureus secretes a number of host-injurious toxins, among the most prominent of which is the small β-barrel pore-forming toxin α-hemolysin. Initially named based on its properties as a red blood cell lytic toxin, early studies suggested a far greater complexity of α-hemolysin action as nucleated cells also exhibited distinct responses to intoxication. The hemolysin, most aptly referred to as α-toxin based on its broad range of cellular specificity, has long been recognized as an important cause of injury in the context of both skin necrosis and lethal infection. The recent identification of ADAM10 as a cellular receptor for α-toxin has provided keen insight on the biology of toxin action during disease pathogenesis, demonstrating the molecular mechanisms by which the toxin causes tissue barrier disruption at host interfaces lined by epithelial or endothelial cells. This review highlights both the historical studies that laid the groundwork for nearly a century of research on α-toxin and key findings on the structural and functional biology of the toxin, in addition to discussing emerging observations that have significantly expanded our understanding of this toxin in S. aureus disease. The identification of ADAM10 as a proteinaceous receptor for the toxin not only provides a greater appreciation of truths uncovered by many historic studies, but now affords the opportunity to more extensively probe and understand the role of α-toxin in modulation of the complex interaction of S. aureus with its human host.
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            Leukocidins: staphylococcal bi-component pore-forming toxins find their receptors

            In this Review, Spaan, van Strijp and Torres discuss the implications of the identification of the cellular receptors for the Staphylococcus aureus bi-component leukocidins, the mechanisms of action of the leukocidins, their diverse roles during pathogenesis and their potential as targets for therapeutic interventions.
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              Staphylococcus aureus toxins.

              Staphylococcus aureus is a dangerous pathogen that causes a variety of severe diseases. The virulence of S. aureus is defined by a large repertoire of virulence factors, among which secreted toxins play a preeminent role. Many S. aureus toxins damage biological membranes, leading to cell death. In particular, S. aureus produces potent hemolysins and leukotoxins. Among the latter, some were recently identified to lyse neutrophils after ingestion, representing an especially powerful weapon against bacterial elimination by innate host defense. Furthermore, S. aureus secretes many factors that inhibit the complement cascade or prevent recognition by host defenses. Several further toxins add to this multi-faceted program of S. aureus to evade elimination in the host. This review will give an overview over S. aureus toxins focusing on recent advances in our understanding of how leukotoxins work in receptor-mediated or receptor-independent fashions. Published by Elsevier Ltd.
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                Author and article information

                Journal
                1886
                European Journal of Microbiology and Immunology
                EuJMI
                Akadémiai Kiadó
                2062-8633
                June 2018
                : 8
                : 2
                : 31-33
                Affiliations
                [1 ]Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg , Bernhard Nocht Str. 74, 20359 Hamburg, Germany
                [2 ]Department of Medical Microbiology, Virology and Hygiene, University Medicine Rostock , Schillingallee 70, 18057 Rostock, Germany
                Author notes
                [*]

                Corresponding author: Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, Bernhard Nocht street 74, D-20359 Hamburg, Germany; Frickmann@ 123456bnitm.de , hagen.frickmann@ 123456med.uni-rostock.de .

                Article
                10.1556/1886.2018.00012
                6038538
                29997908
                ef0676f5-3a20-4320-a19d-354bc907ecf1
                © 2018 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes - if any - are indicated.

                History
                : 25 May 2018
                : 1 June 2018
                : 20 June 2018
                Page count
                Pages: 3
                Categories
                Review Paper

                Medicine,Immunology,Health & Social care,Microbiology & Virology,Infectious disease & Microbiology
                military medicine,molecular detection,molecular point of care testing,MRSA,transmission prevention

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