Globally, Staphylococcus aureus (S. aureus) stands out as the primary pathogen responsible for burn infections, predominantly acquired in hospital settings, with a tendency to infect the skin and inhabit the human nares. Approximately 20–40% of the population is affected by skin infections caused by S. aureus. The microorganism utilizes quorum sensing for cell-to-cell communication, facilitating its colonization at various sites [1].
S. aureus is renowned as one of the most significant bacteria causing diseases in humans. It is implicated in various infections of the skin and soft tissues, such as abscesses (boils), furuncles, and cellulitis, as well as more severe conditions including pneumonia, osteomyelitis, and septicemia, albeit most of these infections are typically not highly severe [2, 3].
The bacterium is accountable for numerous serious skin infections, establishing it as one of the most notorious and prevalent bacterial pathogens. Each year, a substantial number of individuals worldwide suffer from skin diseases caused by S. aureus. Moreover, it contributes to pneumonia, respiratory tract infections, cardiovascular complications, and other hospital-acquired infections [4, 5].
S. aureus bloodstream infections have been documented at an annual rate of 20–50 per 100,000 individuals, with a mortality rate ranging from 10–30 percent. In the United States alone, S. aureus bacteremia is responsible for an estimated 20,000 deaths annually. While less immediately life-threatening, moderately severe skin infections caused by S. aureus, such as furuncles, abscesses, and wound infections, can still result in significant morbidity [6, 7]. The mortality and morbidity rates associated with S. aureus bloodstream infections surpass those of other diseases such as viral hepatitis, acquired immune deficiency syndrome, and tuberculosis. Additionally, S. aureus has been linked to atopic dermatitis, contributing to a substantial global public health burden [8].
Horizontal gene transfers enable Staphylococcus aureus to acquire antibiotic-resistant genes, leading to resistance against various antibiotics [9]. These genes may have evolved in antibiotic producers as a defense mechanism against inhibitory molecules, facilitating their survival in competitive environments. The prevalence of antibiotic-resistant bacteria, including those resistant to methicillin, is increasing globally, particularly in healthcare settings like burn units, where methicillin-resistant S. aureus (MRSA) has become a significant nosocomial pathogen [10].
Treatment of MRSA infections often involves antibiotics such as quinupristin, dalfopristin, and glycopeptides like vancomycin. However, resistance to these antibiotics, as well as to oxacillin, methicillin, tetracycline, and tigecycline, is observed in many strains of S. aureus. In some cases, resistance to vancomycin and linezolid may also have emerged [8].
The development of drug resistance in S. aureus is facilitated by mobile genetic elements (MGEs), which are transferred via horizontal gene transfer. These elements encode virulence factors and antibiotic resistance mechanisms, including resistance to beta-lactam antibiotics [11].
The emergence of methicillin-resistant S. aureus (MRSA) and vancomycin-resistant S. aureus (VRSA) underscores the urgent need for new antimicrobial agents. Despite the resistance of these strains to commonly used antibiotics, current standards of care recommend antibiotics such as Daptomycin and Linezolid [12]. However, the discovery of new antibiotics has been slow in recent decades, despite the effectiveness of existing drugs in most cases. MRSA infections in burn patients remain a significant concern globally, with reported prevalence rates exceeding 50%, and in some studies, surpassing 66% in recent years [13].
In the era of antibiotic resistance, phages are increasingly recognized as promising candidates for controlling bacterial infections across various domains. Their targeted mechanisms of action have led to their utilization in diverse fields including the food industry, medicine, animal husbandry, biotechnology, and agriculture. Numerous studies have documented the efficacy of phages against various pathogens, including S. aureus. Phages specifically targeting S. aureus have been identified and deployed for their potential in combating S. aureus infections. For instance, in a recent study, a cocktail of phages was assessed for its effectiveness against MRSA both in vivo and in vitro, suggesting a promising avenue for treating S. aureus infections by combining phages with conventional antibiotics [14].
Moreover, it's crucial to note that some bacteriophage genomes harbor genes encoding highly virulent bacterial toxins, rendering the host bacterium pathogenic only upon lysogenization by the toxin-encoding phage. Additionally, the transfer of antibiotic resistance genes to bacteria through phages has been documented. Consequently, research endeavors have been initiated to leverage phages for gene insertion into desired bacterial strains, with previous studies demonstrating feasibility and ongoing plans for further exploration [15].
The present research was designed to isolate Methicillin Resistant Staphylococcus aureus strains from burn patients and ascertain their antibiogram patterns. Furthermore, a central objective of this study was the isolation and characterization of bacteriophages specifically targeting Methicillin Resistant Staphylococcus aureus.