Emergence of Vancomycin Resistance inStaphylococcus aureus

Abstract

The emergence of S. aureus with intermediate resistance to glycopeptides emphasizes the importance of the prudent use of antibiotics, the laboratory capacity to identify resistant strains, and the use of infection-control precautions to prevent transmission.

Vancomycin use in a hospital with high prevalence of Methicillin-Resistant Staphylococcus aureus: comparison with Hospital Infection Control Practices Advisory Committe Guidelines (HICPAC)

“…Infections caused by strains of Staphylococcus aureus with reduced susceptibility to vancomycin (minimum inhibitory concentration = 8 µg/mL) were described in Japan and United States, each case occurred following a prolonged course of vancomycin therapy [20][21][22]. In the United States clinical infections with vancomycin resistant Staphylococcus aureus (VRSA) were reported, in 2002 [23][24][25][26]. Vancomycin resistance in Staphylococci is also a concern, and Vancomycin intermediate resistant S. aureus has been described in Brazil [27][28][29].…”

Use of Glycopeptides at a French Teaching Hospital

“…(IB)." 3 Systematic disinfection before entering and leaving a patient's room complies with this guideline and, as recommended, might be a good educational means to improve hand washing, as noted by Voss et al 1 In the same guideline, the technique recommended for hand disinfection is stated: "When decontaminating hands with an alcohol-based hand rub, apply product to palm of one hand and rub hands together, covering all surfaces of hands and fingers, until hands are dry (IB)." 3 No mention is made of time or of the quantity of alcohol to be used because too few data are given in the literature.…”

Innate defences against methicillin‐resistant Staphylococcus aureus (MRSA) infection

“…Vancomycin binds to the peptidoglycan precursor and then inhibits the incorporation of newly synthesized precursors in the cell wall peptidoglycan, thus causing inhibition of cell wall synthesis. Recently, vancomycin-intermediate susceptible S. aureus (VISA), or glycopeptide-intermediate susceptible S. aureus (GISA), emerged [27][28][29][30][31], followed in the USA by a vancomycin-resistant S. aureus (VRSA) [32,33]. The mechanism of vancomycin resistance in the VRSA is due to expression of the vanA gene, which modifies the structure of the peptidoglycan, causing a loss of affinity of vancomycin for the peptidoglycan precursor [34].…”