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Biosensor for Detection of Antibiotic Resistant Staphylococcus Bacteria
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Systematic Review and Meta-Analysis of the Epidemiology of Vancomycin-Intermediate and Heterogeneous

Shanshan Zhang1, Xiaoxi Sun2, Wenjiao Chang2

  • 1School of Medicine, Shandong University, Ji'nan, 250061, PR China.

Plos One
|August 20, 2015
PubMed
Abstract

Insights

The prevalence of vancomycin-intermediate Staphylococcus aureus (VISA) and heterogeneous VISA (hVISA) is increasing and underestimated. These strains are more common in Asia and in blood cultures, highlighting the need for strengthened detection and control measures.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Epidemiology

Background:

  • Vancomycin-intermediate Staphylococcus aureus (VISA) and heterogeneous VISA (hVISA) are critical challenges in treating MRSA infections, linked to vancomycin treatment failures.
  • The increasing prevalence of VISA and hVISA poses a significant public health concern globally.
  • Understanding the epidemiology and genetic background of these resistant strains is crucial for effective control.

Purpose of the Study:

  • To systematically review and analyze the incidence and prevalence of hVISA and VISA across different geographical regions, time periods, and clinical sample types.
  • To investigate the genetic characteristics, including SCCmec types and Sequence Types (STs), associated with hVISA and VISA.
  • To provide a comprehensive epidemiological overview of hVISA/VISA to inform public health strategies.

Main Methods:

  • A systematic literature review was conducted using PubMed and EMBASE databases, covering publications from January 1997 to August 2014.
  • Included studies reported prevalence rates of hVISA and VISA among methicillin-resistant Staphylococcus aureus (MRSA) strains.
  • Subgroup analyses were performed based on study year, geographical location, and type of clinical sample.

Main Results:

  • The pooled prevalence of hVISA was 6.05% and VISA was 3.01% among 99,042 and 68,792 MRSA strains, respectively.
  • Prevalence rates for both hVISA and VISA showed an increasing trend from 2006 to 2014.
  • Higher prevalence of hVISA (6.81%) and VISA (3.42%) was observed in Asia compared to Europe/America (5.60% and 2.75%, respectively). hVISA was frequently isolated from blood cultures (9.81%).
  • SCCmec type II was the most common genotype (48.16% for hVISA, 37.74% for VISA), and ST239 was the most prevalent sequence type.

Conclusions:

  • The prevalence of hVISA/VISA is increasing and likely underestimated, with higher rates in Asia.
  • hVISA is more frequently isolated from blood cultures than other clinical samples, indicating potential for bloodstream infections.
  • These resistant strains are common in epidemic MRSA, necessitating enhanced detection and strengthened control of nosocomial infections.

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