Methicillin-resistant Staphylococcus aureus (MRSA) with reduced susceptibility to glycopeptides (GISA) in 63 French general hospitals

Abstract

Clinical isolates of methicillin-resistant Staphylococcus aureus (n = 1070) collected from 63 French general hospitals during June 2000 (n = 1070) were screened initially for reduced susceptibility to glycopeptides (GISA) on brain-heart infusion agar containing teicoplanin 6 mg/L. Glycopeptide MICs were determined for the 145 isolates that grew on the screening plates. Of the 1070 isolates, 1.4% were GISA on Mueller-Hinton agar, and 2.9% by Etest with a high inoculum, while 0.7% and 2.9% were GISA by vancomycin and teicoplanin population analysis profiles, respectively. Most isolates were resistant to gentamicin and rifampicin or fosfomycin or fusidic acid, as determined by disk diffusion. Pulsed-field gel electrophoresis of the 31 GISA isolates identified four clones, with dissemination of one predominant clone. In these French hospitals there was a low incidence of GISA and hetero-GISA.

Increased Vancomycin MICs for Staphylococcus aureus Clinical Isolates from a University Hospital during a 5-Year Period

“…aureus clinical isolates with reduced susceptibility to vancomycin have been reported from selected patient populations and study sites using various testing methods (e.g., agar dilution, broth microdilution, Etest, agar screening, and population studies) (2,9,15,16,32). However, only a few cases of VRSA or VISA infections have been documented to date.…”

Activity of tigecycline against clinical isolates of Staphylococcus aureus and extended-spectrum β-lactamase-producing Escherichia coli in Granada, Spain

“…Glycopeptides such as vancomycin or teicoplanin are generally the antibiotics of choice for the treatment of MRSA infections. The emergence of GISA [8] suggests that the use of glycopeptides may be limited and it may be necessary to look for alternatives. Several studies show that tigecycline is as active as imipenem in the treatment of intra-abdominal infections (where it is necessary to cover the presence of Gram-negative pathogens such as Enterobacteriaceae) and as active as the combination of vancomycin and aztreonam in skin and soft tissue infections (where it is necessary to cover the presence of MRSA and Gram-negative pathogens) [16].…”

“…Although this is not currently a significant problem in Europe, there have been reports of infections caused by S. aureus with reduced susceptibility to glycopeptides (glycopeptide-intermediate S. aureus (GISA)) [8]. This situation is particularly problematic given the lack of available therapeutic alternatives.…”

Epidemiology and Clinical Impact of Glycopeptide Resistance in Staphylococcus aureus

“…Several studies have been conducted in Europe (France [27,[44][45][46][47][48][49], Germany [50,51], Italy [52], Netherlands [20], Spain [53], United Kingdom [54,55]), Asia -Hong Kong [56], Japan [19,57,58], Korea [59,60]), South America -Brazil [61]), and North America -USA [62][63][64]). Reported prevalence rates vary greatly between, as well as within continents (Table 4).…”