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Related Experiment Videos

Implications of vancomycin-resistant Staphylococcus aureus.

F C Tenover1

  • 1Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. fnt1@CDC.GOV

The Journal of Hospital Infection
|February 5, 2000
PubMed
Summary
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Globally, Staphylococcus aureus strains show reduced susceptibility to glycopeptides like vancomycin, often linked to treatment failures. Current lab tests struggle to detect these glycopeptide-intermediate S. aureus (GISA) strains, hindering surveillance efforts.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Reduced susceptibility to glycopeptides, including vancomycin, has been identified in Staphylococcus aureus strains across Japan, the US, Europe, and the Far East.
  • These glycopeptide-intermediate S. aureus (GISA) strains are associated with vancomycin treatment failures.
  • Some GISA strains exhibit vancomycin Minimum Inhibitory Concentrations (MICs) of 8 µg/mL, while others show heteroresistance with MICs of 1-2 µg/mL.

Purpose of the Study:

  • To report the global emergence of Staphylococcus aureus strains with reduced glycopeptide susceptibility.
  • To highlight the challenges in detecting GISA strains using standard laboratory methods.
  • To discuss the implications for surveillance and therapeutic strategies.

Main Methods:

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  • Broth microdilution testing to determine vancomycin MICs.
  • Analysis of reported GISA isolates from various geographical regions.
  • Evaluation of standard antimicrobial susceptibility testing methods for GISA detection.

Main Results:

  • GISA strains have been isolated in Japan, the US, France, the UK, Spain, Hong Kong, and Korea.
  • US, French, and some Japanese isolates have vancomycin MICs of 8 µg/mL, potentially arising from methicillin-resistant S. aureus (MRSA) infections.
  • European strains often exhibit heteroresistance with vancomycin MICs of 1-2 µg/mL.
  • Standard disk diffusion, Stoke's method, and automated methods often fail to detect GISA.
  • Nosocomial spread of GISA has not been observed in the US or Europe, but has occurred in Japan.

Conclusions:

  • The worldwide isolation of GISA strains suggests this is an ongoing global phenomenon.
  • Current susceptibility testing methods are inadequate for reliable GISA screening, necessitating the use of specific techniques.
  • Effective surveillance for GISA is crucial to monitor the spread and manage infections caused by these resistant strains.