Global prevalence and distribution of vancomycin resistant, vancomycin intermediate and heterogeneously vancomycin intermediate Staphylococcus aureus clinical isolates: a systematic review and meta-analysis

Abstract

Vancomycin-resistant Staphylococcus aureus (VRSA), Vancomycin-intermediate S. aureus (VISA) and heterogeneous VISA (hVISA) are subject to vancomycin treatment failure. The aim of the present study was to determine their precise prevalence and investigate prevalence variability depending on different years and locations. Several international databases including Medline (PubMed), Embase and Web of Sciences were searched (data from 1997 to 2019) to identify studies that addressed the prevalence of VRSA, VISA and hVISA among human clinical isolates around the world. Subgroup analyses and meta-regression were conducted to indicate potential source of variation. Publication bias was assessed using Egger’s test. Statistical analyses were conducted using STATA software (version 14.0). Data analysis showed that VRSA, VISA and hVISA isolates were reported in 23, 50 and 82 studies, with an overall prevalence of 1.5% among 5855 S. aureus isolates, 1.7% among 22,277 strains and 4.6% among 47,721 strains, respectively. The overall prevalence of VRSA, VISA, and hVISA before 2010 was 1.2%, 1.2%, and 4%, respectively, while their prevalence after this year has reached 2.4%, 4.3%, and 5.3%. The results of this study showed that the frequency of VRSA, VISA and hVISA after 2010 represent a 2.0, 3.6 and 1.3-fold increase over prior years. In a subgroup analysis of different strain origins, the highest frequency of VRSA (3.6%) and hVISA (5.2%) was encountered in the USA while VISA (2.1%) was more prevalent in Asia. Meta-regression analysis showed significant increasing of VISA prevalence in recent years ( p value ≤ 0.05). Based on the results of case reports (which were not included in the calculations mentioned above), the numbers of VRSA, VISA and hVISA isolates were 12, 24 and 14, respectively, among different continents. Since the prevalence of VRSA, VISA and hVISA has been increasing in recent years (especially in the Asian and American continents), rigorous monitoring of vancomycin treatment, it’s the therapeutic response and the definition of appropriate control guidelines depending on geographical regions is highly recommended and essential to prevent the further spread of vancomycin-resistant S. aureus .

Staphylococcus aureus in Intensive Pig Production in South Africa: Antibiotic Resistance, Virulence Determinants, and Clonality

“…More so, vancomycin resistance may also be caused by decreased permeability by thickening the cell wall, thus inhibiting/decreasing vancomycin availability to intracellular target molecules [ 58 ]. High percentage resistance to teicoplanin was also observed in the study; however, this was not peculiar, as cross-resistance between glycopeptides has been reported [ 52 , 53 ].…”

“…This finding was similar to that of Sieber et al in a Danish study on LA-MRSA in pigs and humans [ 51 ]. However, other studies have reported a comparatively higher prevalence of tet M than tet K [ 52 , 53 ]. It has been established that most MRSA harbour both tet K and tet M, which confer resistance to all tetracycline antibiotics [ 54 ].…”

Methicillin and Vancomycin Resistant Staphylococcus aureus and Associated Factors from Surgical Ward Inpatients at Debre Markos Referral Hospital, Northwest Ethiopia

“…Deep wound infection (p = 0.043), previous wound infection (p = 0.006) and hospital stay > 72 h (p = 0.001) also demonstrated an association with MRSA infection. Unlike our study a studies by Shariati, (2020) found an association between several variables (hemodialysis dependence, long-term use of vancomycin, hospitalization in ICU and use of indwelling devices ) [27]. Apparent absence of association between variables and VRSA in the present study might be due to small sample size.…”

“…3) (VISA &VRSA). With this cut of value, our nding becomes comparable with several countries [8,24,25].…”

Management of Staphylococcus aureus Bloodstream Infections

“…Altogether, occurrence of isolates with reduced susceptibility to vancomycin has increased over the last years probably also due to more frequent use of vancomycin in patients with MRSA infections ( 51 ). However, prevalence is still low with under 5% and daptomycin remains an effective treatment option in these isolates ( 52 , 53 ).…”