Video:Vancomycin-resistant Staphylococcus aureus

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Vancomycin-resistant Staphylococcus aureus (Tutorial)
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Description

Vancomycin-resistant Staphylococcus aureus are strains of Staphylococcus aureus that have become resistant to the glycopeptide antibiotic vancomycin.[1]This resistance can occur through random mutations or the transfer of DNA from one bacterium to another. VRSA is a significant concern because it limits the treatment options for infections due to these bacteria.[2][3]

Type 1

VISA, VRSA, and hVISA are related but distinct types of antibiotic resistance in Staphylococcus aureus. vancomycin-intermediate S. aureus (VISA), heterogeneous vancomycin-intermediate S. aureus (hVISA), and high-level vancomycin-resistant S. aureus (VRSA).[4]Vancomycin-intermediate S. aureus was first identified in Japan in 1996[5] and has since been found in hospitals elsewhere in Asia, as well as in the United Kingdom, France, the U.S., and Brazil.

Type 2

In 2002, a VRSA strain was isolated from a individual in Michigan.[6] The isolate contained the mecA gene for methicillin resistance. Vancomycin MICs of the VRSA isolate were consistent with the VanA phenotype of Enterococcus species, and the presence of the vanA gene was confirmed by polymerase chain reaction. The DNA sequence of the VRSA vanA gene was identical to that of a vancomycin-resistant strain of Enterococcus faecalis recovered from the same catheter tip. The vanA gene was later found to be encoded within a transposon located on a plasmid carried by the VRSA isolate. This transposon, Tn1546, confers vanA-type vancomycin resistance in enterococci.[7][8][6]

Type 3

The definition of Heterogeneous vancomycin-intermediate S. aureus hVISA according to Hiramatsu et al. is a strain of Staphylococcus aureus that gives resistance to vancomycin at a frequency of ten to the minus six colonies or higher.[9]

Presentation

In terms of the presentation of VRSA we find that it can cause skin conditions like pimples(or boils) and be red, inflamed, and/or warm .[10]

Complications

Among the complications an individual with VRSA may encounter are: sepsis, bone infection and urinary tract infection.[11][10]

Risk factors

Among the possible risk factors for VRSA are the following: prior MRSA infection, chronic skin ulcers and diabetes.[12]

Mechanism

Strains of hVISA and vancomycin-intermediate Staphylococcus aureus (VISA) do not have resistant genes found in Enterococcus and the proposed mechanisms of resistance include the sequential mutations resulting in a thicker cell wall and the synthesis of excess amounts of D-ala-D-ala residues.[13]

Diagnosis

The diagnosis of vancomycin-resistant Staphylococcus aureus can be done with either automated susceptibility testing or non-automated susceptibility testing .[14][15][2]

Differential diagnosis

The differential diagnosis of VRSA in an infected individual is as follows: methicillin-resistant Staphylococcus aureus and other gram-positive infections.[16]

Prevention

In terms of preventing VRSA infection anyone who has physical contact with an infected individual should maintain hands clean by using alcohol-based hand sanitizer.[17]

Treatment

The approach is to treat with at least one agent to which VISA/VRSA is known to be susceptible by in vitro testing. The agents that are used include daptomycin, linezolid, telavancin, ceftaroline, quinupristin–dalfopristin.[18]

Epidemiology 1

In terms of the epidemiology of VRSA we find cases have been reported in several countries, including Brazil, India, Iran, Pakistan, Portugal and United States.[19] We find the prevalence of VRSA varies by region, for instance in Ethiopia it is around 14 (point) 52 percent. It can be interpreted as that the prevalence rates are higher in developing countries compared to developed ones, generally speaking.[20]

Epidemiology 2

The prevalence of vancomycin-resistant Staphylococcus aureus (VRSA) varies by region, and has been increasing in recent years:Asia 1 (point) 2 percent, Europe 1 (point) 1 percent, America 3 (point) 6 percent and Africa 2 (point) 5 percent.[21]

History

The Centers for Disease Control and Prevention reported in the year 2002, that the first case worldwide of VRSA occurred in a 40 year old female from the state of Michigan in the U.S.[22]

References

  1. "CDC - VISA / VRSA in Healthcare Settings - HAI". www.cdc.gov. Archived from the original on 2015-04-28. Retrieved 2015-06-11.
  2. 2.0 2.1 "VRSA" (PDF). cdc. Archived (PDF) from the original on 1 October 2024. Retrieved 5 October 2024.
  3. "Laboratory Testing for Vancomycin-resistant Staphylococcus aureus". Staphylococcus aureus. 15 April 2024. Retrieved 14 October 2024.
  4. Appelbaum PC (November 2007). "Reduced glycopeptide susceptibility in methicillin-resistant Staphylococcus aureus (MRSA)". Int. J. Antimicrob. Agents. 30 (5): 398–408. doi:10.1016/j.ijantimicag.2007.07.011. PMID 17888634.
  5. Hiramatsu, K.; Hanaki, H.; Ino, T.; Yabuta, K.; Oguri, T.; Tenover, F. C. (1997-07-01). "Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility". Journal of Antimicrobial Chemotherapy. 40 (1): 135–136. doi:10.1093/jac/40.1.135. ISSN 0305-7453. PMID 9249217.
  6. 6.0 6.1 Amábile-Cuevas, Carlos F. (2007). Antimicrobial Resistance in Bacteria. Horizon Scientific Press. ISBN 9781904933243.
  7. Courvalin P (January 2006). "Vancomycin resistance in gram-positive cocci". Clin. Infect. Dis. 42 Suppl 1: S25–34. doi:10.1086/491711. PMID 16323116.
  8. "Staphylococcus aureus Resistant to Vancomycin --- United States, 2002". www.cdc.gov. Archived from the original on 8 October 2024. Retrieved 6 October 2024.
  9. Lu, Yichen; Essex, Max; Roberts, Bryan (2008-04-11). Emerging Infections in Asia. Springer Science & Business Media. ISBN 9780387757216.
  10. 10.0 10.1 "Vancomycin-Intermediate/Resistant Staphylococcus aureus (VISA/VRSA) | Wisconsin Department of Health Services". www.dhs.wisconsin.gov. 1 October 2021. Retrieved 9 October 2024.
  11. Selim, Samy; Faried, Osama Ahmed; Almuhayawi, Mohammed S.; Saleh, Fayez M.; Sharaf, Mohamed; El Nahhas, Nihal; Warrad, Mona (18 March 2022). "Incidence of Vancomycin-Resistant Staphylococcus aureus Strains among Patients with Urinary Tract Infections". Antibiotics. 11 (3): 408. doi:10.3390/antibiotics11030408. ISSN 2079-6382. Archived from the original on 9 October 2024. Retrieved 7 October 2024.
  12. "Clinician Brief: Clinical Laboratories' and Infection Preventionists' Roles in the Search for and Containment of Vancomycin-Resistant Staphylococcus aureus". Staphylococcus aureus. 16 May 2024. Retrieved 10 October 2024.
  13. Howden, Benjamin P.; Davies, John K.; Johnson, Paul D. R.; Stinear, Timothy P.; Grayson, M. Lindsay (2010-01-01). "Reduced Vancomycin Susceptibility in Staphylococcus aureus, Including Vancomycin-Intermediate and Heterogeneous Vancomycin-Intermediate Strains: Resistance Mechanisms, Laboratory Detection, and Clinical Implications". Clinical Microbiology Reviews. 23 (1): 99–139. doi:10.1128/CMR.00042-09. ISSN 0893-8512. PMC 2806658. PMID 20065327.
  14. Loomba, Poonam Sood; Taneja, Juhi; Mishra, Bibhabati (2010-01-01). "Methicillin and Vancomycin Resistant S. aureus in Hospitalized Patients". Journal of Global Infectious Diseases. 2 (3): 275–283. doi:10.4103/0974-777X.68535. ISSN 0974-777X. PMC 2946685. PMID 20927290.
  15. "Laboratory Testing for Vancomycin-resistant Staphylococcus aureus". Staphylococcus aureus. 15 April 2024. Archived from the original on 27 September 2024. Retrieved 5 October 2024.
  16. Weinstein, R. A.; Fridkin, S. K. (1 January 2001). "Vancomycin-Intermediate and -Resistant Staphylococcus aureus: What the Infectious Disease Specialist Needs to Know". Clinical Infectious Diseases. 32 (1): 108–115. doi:10.1086/317542. Retrieved 10 October 2024.
  17. "About Vancomycin-resistant Staphylococcus aureus". Staphylococcus aureus. 9 July 2024.
  18. Liu, Catherine; Bayer, Arnold; Cosgrove, Sara E.; Daum, Robert S.; Fridkin, Scott K.; Gorwitz, Rachel J.; Kaplan, Sheldon L.; Karchmer, Adolf W.; Levine, Donald P.; Murray, Barbara E.; Rybak, Michael J.; Talan, David A.; Chambers, Henry F. (1 February 2011). "Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus aureus Infections in Adults and Children". Clinical Infectious Diseases. 52 (3): e18–e55. doi:10.1093/cid/ciq146. Retrieved 23 October 2024.
  19. Blechman, Samuel E.; Wright, Erik S. (29 August 2024). "Vancomycin-resistant Staphylococcus aureus (VRSA) can overcome the cost of antibiotic resistance and may threaten vancomycin's clinical durability". PLOS Pathogens. 20 (8): e1012422. doi:10.1371/journal.ppat.1012422. ISSN 1553-7374. Archived from the original on 20 September 2024. Retrieved 24 September 2024.
  20. Belete, Melaku Ashagrie; Gedefie, Alemu; Alemayehu, Ermiyas; Debash, Habtu; Mohammed, Ousman; Gebretsadik, Daniel; Ebrahim, Hussen; Tilahun, Mihret (30 August 2023). "The prevalence of vancomycin-resistant Staphylococcus aureus in Ethiopia: a systematic review and meta-analysis". Antimicrobial Resistance & Infection Control. 12 (1): 86. doi:10.1186/s13756-023-01291-3. ISSN 2047-2994.
  21. Shariati, Aref; Dadashi, Masoud; Moghadam, Majid Taati; van Belkum, Alex; Yaslianifard, Somayeh; Darban-Sarokhalil, Davood (29 July 2020). "Global prevalence and distribution of vancomycin resistant, vancomycin intermediate and heterogeneously vancomycin intermediate Staphylococcus aureus clinical isolates: a systematic review and meta-analysis". Scientific Reports. 10 (1): 12689. doi:10.1038/s41598-020-69058-z. ISSN 2045-2322.
  22. Gottlieb, Scott (12 April 2003). "CDC reports first case of vancomycin resistant Staphylococcus aureus". BMJ. p. 783. doi:10.1136/bmj.326.7393.783/a. Archived from the original on 2 October 2024. Retrieved 2 October 2024.