Detection of an outbreak of methicillin-resistant Staphylococcus aureus with reduced susceptibility to glycopeptides in a French hospital

Mallaval, F.; Carricajo, Anne; Delavenna, F.; Recule, C.; Fonsale, Nathalie; Manquat, G.; Raffenot, D.; Rogeaux, O.; Aubert, G.; Tous, J.

doi:10.1111/j.1469-0691.2004.00878.x

Cited by 17 publications

(11 citation statements)

References 13 publications

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“…The prevalence of VISA or hVISA amongst MRSA isolates ranged from 0.1% (hVISA) and 0.3% (VISA) in Belgium [24] to 11% (VISA) in France and 18% in Turkey (hVISA) [25,26]. Furthermore, an outbreak due to VISA in a French hospital has been reported [27]. Our finding that all of the 21 patients with VISA had the same PFGE type (pulsotype A) suggests that clonal spreads of VISA have occurred.…”

Section: Discussionmentioning

confidence: 69%

Clonal dissemination of meticillin-resistant and vancomycin-intermediate Staphylococcus aureus in a Taiwanese hospital

Hsueh

Lee

Perng

et al. 2010

International Journal of Antimicrobial Agents

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Section: Discussionmentioning

confidence: 69%

Clonal dissemination of meticillin-resistant and vancomycin-intermediate Staphylococcus aureus in a Taiwanese hospital

Hsueh

Lee

Perng

et al. 2010

International Journal of Antimicrobial Agents

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“…The reported prevalence of h‐GISA isolates ranges widely from one study to another, but was similarly low (<1%) in large surveys conducted in the UK, Italy, USA and Korea [16–19]. In contrast, a higher prevalence was observed among MRSA isolates analysed in Japan (5–22%), Germany (2–14%), The Netherlands (7.6%) and France (20%) [7,13,20,21], although other studies in France have reported lower incidences of h‐GISA (0.6–5%) [22,23]. However, such differences may be more apparent than real because of marked differences in the study design and laboratory methods used for screening and confirming the hetero‐resistance phenotype.…”

Section: Discussionmentioning

confidence: 99%

Low prevalence of methicillin-resistant Staphylococcus aureus with reduced susceptibility to glycopeptides in Belgian hospitals

Nonhoff

Denis

Struelens

2005

Clinical Microbiology and Infection

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Staphylococcus aureus strains with decreased susceptibility to glycopeptides (GISA) have been associated with increased risk of glycopeptide treatment failure. To assess the prevalence of these strains in hospitalised patients in Belgium, 455 methicillin-resistant S. aureus (MRSA) isolates collected in 2001 were screened by two assays: (i) growth on vancomycin agar screen (VAS; brain heart infusion agar (BHI) + vancomycin 6 mg/L); and (ii) a synergy/antagonism test with aztreonam/cefazolin on Mu3 agar (BHI + vancomycin 3 mg/mL). Isolates growing on VAS or Mu3 agar were characterised further by analysis of population susceptibility profiles. MICs of glycopeptides were determined by agar dilution, broth microdilution and Etest (low and high inocula) methods. The isolates were genotyped by pulsed-field gel electrophoresis (PFGE) and determination of staphylococcal cassette chromosome mec (SCCmec) type. No GISA isolates were found. Three (0.7%) hetero-vancomycin intermediate S. aureus (hVISA) and ten (2.2%) hetero-teicoplanin intermediate S. aureus (hTISA) isolates were identified by population analysis. All but one hetero-GISA isolate belonged to either epidemic PFGE group A/SCCmec type I (69%) or PFGE group D/SCCmec type I (23%), both of which were resistant to gentamicin. The sensitivity and specificity for the detection of hetero-GISA by the two assays were 15.4% and 99.8%, respectively, for VAS, and 84.6% and 95.9%, respectively, for Mu3. The data indicated that hetero-GISA strains were uncommon among Belgian MRSA isolates from hospitalised patients. Use of Mu3 agar was more sensitive, but less specific, than VAS as a screening method.

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“…In other cases, a nosocomial spread of hVISA or VISA has been suggested, with a number of outbreaks reported, mostly in France (64,105,190,253). An outbreak reported by de Lassence et al was described as 21 patients in a French ICU who had isolates of S. aureus with reduced glycopeptide susceptibility (64).…”

Section: Global Epidemiology and Associated Features Of Hvisa And Visamentioning

confidence: 99%

Reduced Vancomycin Susceptibility inStaphylococcus aureus, Including Vancomycin-Intermediate and Heterogeneous Vancomycin-Intermediate Strains: Resistance Mechanisms, Laboratory Detection, and Clinical Implications

et al. 2010

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SUMMARY The emergence of vancomycin-intermediate Staphylococcus aureus (VISA) and heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) over the past decade has provided a challenge to diagnostic microbiologists to detect these strains, clinicians treating patients with infections due to these strains, and researchers attempting to understand the resistance mechanisms. Recent data show that these strains have been detected globally and in many cases are associated with glycopeptide treatment failure; however, more rigorous clinical studies are required to clearly define the contribution of hVISA to glycopeptide treatment outcomes. It is now becoming clear that sequential point mutations in key global regulatory genes contribute to the hVISA and VISA phenotypes, which are associated predominately with cell wall thickening and restricted vancomycin access to its site of activity in the division septum; however, the phenotypic features of these strains can vary because the mutations leading to resistance can vary. Interestingly, changes in the staphylococcal surface and expression of agr are likely to impact host-pathogen interactions in hVISA and VISA infections. Given the subtleties of vancomycin susceptibility testing against S. aureus, it is imperative that diagnostic laboratories use well-standardized methods and have a framework for detecting reduced vancomycin susceptibility in S. aureus.

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Detection of an outbreak of methicillin-resistant Staphylococcus aureus with reduced susceptibility to glycopeptides in a French hospital

Cited by 17 publications

References 13 publications

Clonal dissemination of meticillin-resistant and vancomycin-intermediate Staphylococcus aureus in a Taiwanese hospital

Clonal dissemination of meticillin-resistant and vancomycin-intermediate Staphylococcus aureus in a Taiwanese hospital

Low prevalence of methicillin-resistant Staphylococcus aureus with reduced susceptibility to glycopeptides in Belgian hospitals

Reduced Vancomycin Susceptibility inStaphylococcus aureus, Including Vancomycin-Intermediate and Heterogeneous Vancomycin-Intermediate Strains: Resistance Mechanisms, Laboratory Detection, and Clinical Implications

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