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Vancomycin resistance in Staphylococcus aureus
Peter C Appelbaum1, Bülent Bozdogan
1Department of Pathology, Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA. pappelbaum@psu.edu
Clinics in Laboratory Medicine
|June 5, 2004
Summary
Vancomycin resistance, a growing concern in enterococci, has now emerged in Staphylococcus aureus. This development, marked by altered cell walls and resistance mechanisms, poses a significant threat to public health.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Vancomycin resistance in enterococci emerged in the late 1980s.
- Vancomycin resistance in Staphylococcus aureus is a significant and concerning development.
- Vancomycin-intermediate strains exhibit thickened cell walls when exposed to vancomycin.
Purpose of the Study:
- To review the mechanisms and implications of vancomycin resistance in Staphylococcus aureus.
- To highlight the emergence of vancomycin-resistant Staphylococcus aureus (VRSA) infections.
- To emphasize the need for strategies to prevent the further spread of vancomycin resistance.
Main Methods:
- Review of existing literature on vancomycin resistance mechanisms.
- Analysis of reported cases of vancomycin-resistant Staphylococcus aureus infections.
- Examination of genetic mechanisms, including potential gene transfer events.
Main Results:
- Two primary resistance mechanisms identified: altered cell wall synthesis and changes in teichoic acid.
- Reported cases of vancomycin-resistant Staphylococcus aureus infections in 2002.
- Potential vanA gene transfer from Enterococcus faecalis to Staphylococcus aureus observed.
- Variable expression levels of resistance in Staphylococcus aureus strains complicate detection.
Conclusions:
- The emergence of vancomycin resistance in Staphylococcus aureus is a serious clinical concern.
- Understanding resistance mechanisms and spread is crucial for effective treatment and prevention.
- Urgent measures are needed to prevent the further development and dissemination of vancomycin resistance in staphylococci.