Journal Article

Vancomycin-Intermediate and -Resistant <i>Staphylococcus aureus:</i> What the Infectious Disease Specialist Needs to Know

Robert A. Weinstein and Scott K. Fridkin

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 1, pages 108-115
Published in print January 2001 | ISSN: 1058-4838
Published online January 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/317542
Vancomycin-Intermediate and -Resistant Staphylococcus aureus: What the Infectious Disease Specialist Needs to Know

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Ever since the first strain of Staphylococcus aureus with reduced susceptibility to vancomycin and teicoplanin was reported from Japan, there has been a lot of confusion regarding the laboratory and clinical approach to patients with infections due to S. aureus with reduced susceptibility to vancomycin. To date, 6 clinical infections with vancomycin-intermediate S. aureus (VISA) have been reported in the United States. Intermediate resistance appears to develop from preexisting strains of methicillin-resistant S. aureus in the presence of vancomycin, and all but 1 infection occurred in patients with exposure to dialysis for renal insufficiency. Detection of VISA is difficult in the laboratory, and special inquiries about susceptibility testing methods may be needed. These VISA-infected patients had underlying illnesses, and their infections did not appear to respond well to conventional treatment. Prevention strategies have been outlined. Without continued vigilance in enforcing infection-control measures, improved use of antimicrobials, and coordination of efforts among public health authorities, increasing levels of vancomycin resistance in S. aureus are likely to be encountered.

Journal Article.  4740 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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