Journal Article
The virulence toolkit of Staphylococcus aureus: a comprehensive review of toxin diversity, molecular mechanisms, and clinical implications
Stefano Di Bella; Bruna Marini; Giacomo Stroffolini; Nicholas Geremia; Daniele Roberto Giacobbe; Floriana Campanile; Michele Bartoletti; Giulia Alloisio; Ludovica Di Risio; Giulia Viglietti; Luigi Principe; Venera Costantino; Marina Busetti; Verena Zerbato; Filippo Mearelli; Gianni Biolo; Alessio Nunnari; Claudia Maria Cafiero; Alessandra di Masi
European Journal of Clinical Microbiology & Infectious Diseases · Vol. 44, Issue 8 · pp. 1797-1816 · 2025
Abstract
Purpose This review examines the pathogenic mechanisms of Staphylococcus aureus , emphasizing its toxin-driven virulence factors, including pore-forming toxins, exfoliative toxins, and superantigens. Methods This paper was conducted using the available literature (PubMed/MEDLINE/Google Scholar and books written by experts in pharmacology and infectious diseases). Results Toxins are crucial in promoting tissue invasion, immune system evasion, and the development of systemic diseases. Notably, the qualitative and quantitative expression of these toxins influences the clinical presentation and severity of S. aureus infections. The paper explores toxins’ role in S. aureus pathogenesis and clinical manifestations as well as current and emerging therapeutic strategies aimed at targeting these toxins, including antibiotics, monoclonal antibodies, and anti-inflammatory treatments. Additionally, it highlights the potential of novel inhibitors and vaccines to neutralize specific toxins and prevent toxin-mediated diseases. Conclusion By combining antimicrobial therapies with approaches that neutralize toxins and modulate the immune response, clinicians can improve outcomes in patients affected by S. aureus infections.