This change in epidemiology affects choices of empirical antibiotics for skin and skinstructure infections and communityacquired pneumonia in many settings. Vancomycinresistant staphylococcus aureus, michigan, usa. Because alternative treatments are limited, development of resistance to vancomycin can make treatment of mrsa infections increasingly difficult. Management of methicillinresistant staphylococcus aureus. Staphylococcus aureus visa and vancomycin resistant. In recent years there has been an increased prevalence of antibiotic resistant bacterial strains, such as mrsa methicillin resistant staphylococcus aureus and vrsa vancomycin resistant staphylococcus aureus amongst others, which have lead to an increased interest in alternative antimicrobial agents. Rare reports of vancomycin resistant staphylococcus aureus vrsa cause alarm, proving that antibiotic resistance has transferred from other species. Methicillin resistant staphylococcus aureus poses major problems worldwide as a cause of nosocomial infection and has emerged as a cause of communityacquired infections. We aim to analyse the epidemiology and risk factors of methicillin resistant staphylococcus aureus mrsa and vancomycin resistant enterococci vre in zhejiang china. Independent of mrsa infection, vancomycin monitoring is also recommended for all patients at high risk for nephrotoxicity eg, critically ill patients receiving concurrent nephrotoxins, patients with unstable ie, deteriorating or significantly improving renal function, and those receiving prolonged courses of therapy more than 3 to 5 days. Objectives the increase in resistance of methicillin resistant staphylococcus aureus mrsa strains to vancomycin has been perceived as a formidable threat in the therapeutic fields. Vancomycin remains one of the firstline drugs for the treatment of mrsa infections. Resistantbacteria related diseases are a major global health threat that results in infections in an es timated 2 million people, causing 23,000. Vancomycin has been considered to be the reference standard for the treatment of invasive methicillin resistant staphylococcus aureus mrsa infections, as a result of its relatively clean safety profile, its durability against the development of resistance, and, for many years, the lack of other approved alternatives.
Vancomycin continues to be an important antimicrobial agent for treating infections caused by. Approximately 2530 percent of the population is colonized when bacteria are present, but not causing an infection in the nose. Staphylococcus aureus is a common cause of hospital and communityacquired infections 1,2. Staphylococcus aureus vrsa erythromycin resistant group a. Methicillinresistant staphylococcus aureus mrsavancomycin intermediateresistant staphylococcus aureus redirect. Figure 1 graphs of the methicillin resistant staphylococcus aureus mrsa, vancomycin resistant enterococcus vre, and clostridium difficile labid clinical culture rates marker of healthcareassociated infections before and after discontinuing routine contact precautions for endemic mrsa and vre. Efficacy and safety of tigecycline compared with vancomycin or linezolid for treatment of serious infections with methicillinresistant staphylococcus aureus or vancomycin resistant enterococci. Apr 17, 2019 the aim of the present study was to describe the characteristics of infections with staphylococcus aureus with reduced vancomycin susceptibility sarvs including vancomycin intermediate s. Staphylococcus aureus bacteria are commonly found on the skin and in the nose of about 30% of people. Visa and vrsa are specific types of staphylococcus aureus bacteria that have developed resistance to the antibiotic vancomycin. Therapeutic monitoring of vancomycin for serious methicillinresistant staphylococcus aureus infections. Occurrence of cocolonization or co infection with vancomycin resistant enterococci and methicillin resistant staphylococcus aureusin a medical intensive care unit. Anyone can develop a staph infection, although certain groups of people are at greater risk, including people with chronic.
Trimethoprimsulfamethoxazole versus vancomycin for severe. Vancomycinresistant staphylococcus aureus an overview. What are vancomycin intermediate staphylococcus aureus visa and vancomycinresistant staphylococcus aureus vrsa staphylococcus aureus staph is a common type of bacteria germ that is often found on the skin and in the. Investigation and control of vancomycin resistant staphylococcus aureus. Grampositive bacteria are dangerous and challenging agents of infection due to their increasing resistance to antibiotics. The association of vancomycin trough levels with outcomes. Highdose vancomycin therapy for methicillinresistant staphylococcus aureus infections article pdf available in archives of internal medicine 16619. Feb 03, 2020 what is vancomycin resistant staphylococcus aureus infection.
Vancomycin remains the drug of choice for these infections. Alternatives to vancomycin for the treatment of methicillin. Vancomycin has been the most reliable therapeutic agent against infections caused by meticillin resistant staphylococcus aureus mrsa. Relationship between vancomycin resistant staphylococcus aureus, vancomycin intermediate s. In may 1996, the first documented infection with vancomycinintermediate s. Staphylococcus aureus staph is a germ commonly found on the skin and in the nose of many people. Reports in the 1990s suggested that the susceptibility of s. Vancomycin resistant staphylococcus aureus an overview. Vancomycin intermediate staphylococcus aureus visa and vancomycinresistant staphylococcus aureus vrsa infections. Vancomycinresistant staphylococcus aureus vrsa infections, which are always methicillin resistant, are a rare but serious public health concern. Vancomycinintermediateresistant staphylococcus aureus. This seems to be a common resistance mechanism for all vrsa strains isolated in the world so far. The emerging threat of widespread vancomycin resistance poses a serious public health concern given the fact that vancomycin has long been the preferred treatment of antibiotic resistant grampositive organisms.
Complications vrsavisa infection can be treated with antibiotics other than vancomycin. Evaluation of vancomycin mic creep in methicillinresistant. Streptococcus pneumoniae drug resistant tuberculosis. Staphylococcus aureus is a cause of hospital and communityacquired infections 1,2. Methods a retrospective study including patients with vancomycin susceptible mrsa infections mic aug 30, 2011 staphylococcus and vancomycin staphylococcus aureus is one of the most common causes of hospital and community acquired infections, and treatment of staphylococcal infections is complicated by the ability of this bacterial species to become resistant to antibiotics vancomycin is the drug of choice for therapy of infections due to. Vancomycinresistant staphylococcus aureus the lancet.
Fact sheet vancomycinresistant staphylococcus aureus vrsa. Failure of vancomycin in the treatment of staphylococcal infections has been observed and. These bacteria are resistant to the antibiotic medicine vancomycin. Methicillinresistant, vancomycinintermediate and vancomycin. Care guide for vancomycin resistant staphylococcus aureus infection aftercare instructions. Resorting to a metaanalysis approach, this study aims to assess the evidence of vancomycin mic creep. The aim of this study was to determine the association of high compared to low vancomycin mics and clinical outcomes treatment failure and mortality in patients with mrsa. Staphylococcus aureus is responsible for 15% of all bacteremias and is the second most common cause of nosocomial bloodstream infections. Vancomycin intermediate staphylococcus aureus and vancomycin resistant staphylococcus aureus visavrsa 2004 case definition recommend on facebook tweet share compartir note. Feb 03, 2020 care guide for vancomycin resistant staphylococcus aureus infection aftercare instructions. Fact sheet vancomycinresistant staphylococcus aureus vrsa what is staphylococcus aureus staphylococcus aureus, often simply referred to a staph, are bacteria germs commonly found on the skin and in the noses of healthy people. Until recently, the glycopeptide vancomycin remained the only antibiotic effective at infections caused by multiresistant grampositive.
Emergence of vancomycinintermediate staphylococcus aureus visa and. Molecular characterization of vancomycinresistant staphylococcus. Florescu i, beuran m, dimov r, razbadauskas a, bochan m, fichev g, et al. Investigation and control of vancomycinresistant staphylococcus aureus vrsa pdf icon pdf 300 kb this document is a guide to conducting a public health investigation of patients from whom vancomycinresistant staphylococcus aureus vrsa, vancomycin mic. Nccls guidelines define staphylococci for which the mic of vancomycin is. However, an increasing number of mrsa isolates with high mics, within the susceptible range vancomycin mic creep, are being reported worldwide. However, as a result of limited tissue distribution, as well as the emergence of isolates with reduced susceptibility and in vitro resistance to vancomycin, the need for alternative therapies that target mrsa. Vancomycinresistant staphylococcus aureus vrsa infections, which are always methicillinresistant, are a rare but serious public health concern. It can also grow in wounds or other sites in the body, sometimes causing an infection.
High vancomycin minimum inhibitory concentration and. Practice guidelines are systematically developed statements to assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances. Vrsa was neither transmitted to or from another known vrsa patient nor transmitted from patients to identified contacts. Vancomycin resistance in staphylococcus aureus ncbi. What is vancomycin resistant staphylococcus aureus vrsa. Methicillinresistant, vancomycinintermediate and vancomycinresistant staphylococcus aureus infections in solid organ transplantation c.
Vancomycinresistant staphylococcus aureus wikipedia. Methicillin resistance is defined as the strains of s. Vancomycinintermediate staphylococcus aureus and vancomycin. Staphylococcus aureus resistant to vancomycin united states, 2002. Vancomycin intermediate and vancomycin resistant staphylococcus aureus infection case reporting and investigation protocol keywords.
Rare reports of vancomycinresistant staphylococcus aureus vrsa cause alarm, proving that antibiotic resistance has transferred from other species. Investigation and control of vancomycin resistant staphylococcus aureus vrsa pdf icon pdf 300 kb this document is a guide to conducting a public health investigation of patients from whom vancomycin resistant staphylococcus aureus vrsa, vancomycin mic. A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Recent emergence of vancomycin resistance in methicillin resistant staphylococcus aureus vrsa has posed a new threat to hospital infection control and antibiotic chemotherapy. Vancomycin is currently the primary option treatment for methicillin resistant staphylococcus aureus mrsa. What is vancomycin resistant staphylococcus aureus infection. Populations at risk for staphylococcus aureus infection. This consensus revision evaluates the current scientific data and controversies associated with vancomycin dosing and serum concentration monitoring for serious methicillin resistant s. Characterization of infections with vancomycinintermediate.
Elimination of routine contact precautions for endemic. Vancomycin resistant staphylococcus aureus infections. Many infectious diseases became treatable with antibiotics, including those caused by s. The definition of hvisa according to hiramatsu et al. Investigation and control of vancomycinintermediate. Staphylococcus aureus, often referred to as staph, are bacteria commonly carried on the skin or in the nose of healthy people. Vancomycinintermediate staphylococcus aureus visa and. The prevalence of superbugs, such as methicillin resistant staphylococcus aureus mrsa and vancomycin resistant staphylococcus aureus vrsa is increasing rapidly both in hospitals and in the community.
Vancomycinintermediateresistant staphylococcus aureus laboratory testing algorithm. The information reflects the experience gained from field investigations of the first fourteen vrsa identified in the united states. A vancomycin resistant staphylococcus aureus vrsa infection is caused by bacteria. Staphylococcus aureus in healthcare settings hai cdc. Comparative genomics of vancomycin resistant staphylococcus aureus strains and their positions within the clade most commonly associated with methicillin resistant s. Therapeutic monitoring of vancomycin for serious methicillin. When staph enters the body through a break in the skin it can cause mild infections, such as pimples and boils, or serious. Vancomycin resistant staphylococcus aureus infection.
Epidemiology and risk factors staphylococcus aureus is a major cause of infection among solidorgan transplant recipients. In 2005 in the united states, deaths from mrsa approximately 18,000 surpassed deaths from hivaids approximately 17,000, underscoring the need for improved surveillance to prevent and control the spread of this potentially lethal organism. The reduced susceptibility of vancomycin intermediate. Vancomycin resistant staphylococcus aureus vrsa what is staphylococcus aureus staph. Vancomycin, a glycopeptide antibiotic that inhibits cell wall biosynthesis, remains a drug of choice for treatment of severe mrsa infections. A guide for health departments and infection control personnel. Background recent vancomycin pkpd and toxicodynamic studies enable a reassessment of the current dosing and monitoring guideline in an attempt to further optimize the efficacy and safety of. As of may 2015, 14 vrsa infections have been reported in patients from the united states us.
The clsi therefore lowered the vancomycin breakpoint for s. Screening of highrisk patients at the time of hospital admission and. Vancomycinresistant staphylococcus aureus new york, 2004. Investigation and control of vancomycinresistant staphylococcus aureus. Infection with vancomycinresistant staphylococcus aureus. Introduction current guidelines recommend maintaining vancomycin trough concentrations between 1520 mgl for serious methicillin resistant staphylococcus aureus mrsa infections. However, in 1996 the first mrsa to acquire resistance to vancomycin, was isolated from a japanese patient. The infection caused by methicillinresistant staphylococcus aureus mrsa is a global threat to public health. Kos vn, desjardins ca, griggs a, cerqueira g, van tonder a et al. Prevalence of vancomycin resistant staphylococcus aureus. Vancomycin resistance has been reported in clinical isolates of both coagulasenegative staphylococci and staphylococcus aureus. Staphylococcus aureus staph is a common type of bacteria germ that is often found on the skin and in the nose of healthy people. Therapeutic monitoring of vancomycin for serious methicillin resistant staphylococcus aureus infections. Oct 12, 2019 the infection caused by methicillin resistant staphylococcus aureus mrsa is a global threat to public health.
Methicillinresistant staphylococcus aureusand vancomycin. Using genomics to understand meticillin and vancomycin. Japan, however, considers some isolates for which the mic is 8. Vergidisc and the ast infectious diseases community of practice adepartment of internal medicine and infectious diseases, clinica luganese, lugano, switzerland. Vancomycin resistance in staphylococci clinical microbiology. Highdose vancomycin therapy for methicillin resistant staphylococcus aureus infections article pdf available in archives of internal medicine 16619. Fortunately, only 7 cases of vancomycin resistant s. Current concepts in antimicrobial therapy against select. Staphylococcus and vancomycin staphylococcus aureus is one of the most common causes of hospital and communityacquired infections, and treatment of staphylococcal infections is complicated by the ability of this bacterial species to become resistant to antibiotics vancomycin is the drug of choice for therapy of infections due to methicillin methicillin. Vancomycin remains the reference standard for the treatment of systemic infection caused by methicillin resistant staphylococcus aureus mrsa. Pdf highdose vancomycin therapy for methicillinresistant. Background recent vancomycin pkpd and toxicodynamic studies enable a reassessment of the current dosing and monitoring guideline in an attempt to further optimize the efficacy and safety of vancomy. Patients with methicillin resistant staphylococcus aureus mrsa infections caused by isolates with a high but susceptible minimum inhibitory concentration mic to vancomycin may suffer poor outcomes.
In staphylococcus led to the emergence of vancomycinresistant s. Methicillin resistant staphylococcus aureus mrsa emerged in the 1960s as a cause of infection among patients exposed to the bacteria in health care settings. After years of rising incidence, methicillin resistant s. Jan 08, 2020 meticillin and vancomycinresistant staphylococcus aureus have been included by the world health organization in the global priority list of antibioticresistant bacteria, given the high mortality and morbidity associated with invasive s. The infection caused by methicillin resistant staphylococcus aureus mrsa is a global threat to public health. Vancomycinintermediate staphylococcus aureus visa vancomycinresistant staphylococcus aureus vrsa definition.
Since the recognition of vancomycin resistant enterococci in 1988, the emergence of vancomycin resistant s. Vancomycinintermediate staphylococcus aureus visa and vancomycinresistant staphylococcus aureus vrsa january 20 page 2 visa or vrsa infections can cause a range of symptoms including skin infections, abscesses, pneumonia, and infection of the heart valves, bones, or blood. Staphylococcus aureus is one of the most common causes of hospital and communityacquired infections 1,2. Staphylococcus aureus visa and vancomycin resistant staphylococcus aureus vrsa what is staphylococcus aureus. Although mrsa is often better known, any staph infection can be dangerous even if it is not resistant to antibiotics. We agree with tabaqchalis dec 6 commentary3 on vancomycin intermediateresistance s aureus vrsa.
The infection can spread easily from person to person. Methicillinresistant staphylococcus aureus mrsa and vancomycinresistant enterococci vre cause nosocomial infections and are associated with. The development of vancomycin resistant enterococci in 1988 led the way to the emergence of vancomycin resistant s. Vancomycinresistant staphylococcus aureus centers for disease. Vancomycin is a glycopeptide antibiotic that has been in clinical use for nearly 50 years as a penicillin alternative to treat penicillinaseproducing strains of staphylococcus aureus. While most staph bacteria can be treated with an antibiotic known as vancomycin, some have developed a resistance and can no longer be treated with vancomycin. Vancomycinresistant staphylococcus aureus bacterium.
Treatment options for vrsa and vancomycin resistant. Combination antibiotic treatment of serious methicillin. Keiichi hiramatsu and colleagues dec 6, p 16701 report of vancomycin resistant staphylococcus aureus in japan was followed by two further reported cases in michigan and new jersey in the usa. Epidemiology and risk factors of methicillinresistant.
320 1307 327 225 1328 1584 306 620 203 1429 200 1447 895 1174 668 869 1551 1015 967 983 1487 128 1054 1179 500 874 1002 507 684 726 116 1377 260 197 1134 1491 647 932 642 331 199