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Staphylococcus aureus is one of the most frequent worldwide causes of morbidity and mortality due to an infectious agent. This pathogen can cause a wide variety of diseases, ranging from moderately severe skin infections to fatal pneumonia and sepsis. Treatment of S. aureus infections is complicated by antibiotic resistance and a working vaccine is not available. There has been ongoing and increasing interest in the extraordinarily high number of toxins and other virulence determinants that S. aureus produces and how they impact disease. In this review, we will give an overview of how S. aureus initiates and maintains infection and discuss the main determinants involved. A more in-depth understanding of the function and contribution of S. aureus virulence determinants to S. aureus infection will enable us to develop anti-virulence strategies to counteract the lack of an anti-S. aureus vaccine and the ever-increasing shortage of working antibiotics against this important pathogen. [ABSTRACT FROM AUTHOR]

Phenol-soluble modulins (PSMs) are amphipathic peptides produced by staphylococci that have multiple functions in pathogenesis. For example, they may function as cytotoxins and pro-inflammatory agents. Additionally, in a recent study we demonstrated that Staphylococcus aureus PSMs structure biofilms and cause dissemination during biofilm infection. Based on those results suggesting a surfactant-like mechanism by which PSMs work, we here propose that all PSM functions in pathogenesis arose from an original role in non-pathogenic surface colonization. This original role may have included overcoming surface tension in environments of strongly varying hydrophobicity and emulsification of hydrophobic molecules for use as food sources. [ABSTRACT FROM AUTHOR]