[Cloxacillin-susceptible Staphylococcus aureus with high MIC to glycopeptides. Ever we use cloxacillin?]

Alejandra Morales-Cartagena, Antonio Lalueza, Rafael San Juan

  • 1José María Aguado, Unidad de Enfermedades Infecciosas. Hospital Universitario 12 de Octubre, Madrid, Spain. jaguadog1@gmail.com.

Insights

Increasing vancomycin resistance in Staphylococcus aureus strains, including VISA, is a growing concern. This necessitates exploring alternative treatments and understanding the clinical impact of reduced vancomycin susceptibility.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Context:

  • Staphylococcus aureus infections remain a significant cause of illness and death.
  • Rising rates of methicillin-resistant S. aureus (MRSA) have increased vancomycin usage.
  • A concerning rise in vancomycin minimum inhibitory concentration (MIC) for S. aureus has been observed.

Purpose:

  • To highlight the emergence of vancomycin-intermediate S. aureus (VISA) and vancomycin-resistant S. aureus (VRSA) strains.
  • To address the clinical implications of S. aureus strains with decreased vancomycin susceptibility.
  • To underscore the need for further research into the impact of elevated vancomycin MICs.

Summary:

  • The increasing incidence of S. aureus strains with reduced susceptibility to vancomycin, including VISA and VRSA, poses a significant challenge.
  • These resistant strains exhibit altered clinical behavior, irrespective of vancomycin use in both MRSA and methicillin-sensitive S. aureus.
  • The diminishing effectiveness of vancomycin necessitates a re-evaluation of therapeutic strategies for staphylococcal infections.

Impact:

  • The emergence of vancomycin resistance threatens current treatment paradigms for S. aureus infections.
  • Scarcity of alternative treatment options for infections caused by resistant strains is alarming.
  • Further investigation is crucial to fully understand the clinical impact of higher vancomycin MICs in staphylococcal infections.

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