193:
2501:
617:
2531:
2541:
25:
1702:
2521:
2511:
66:
113:
403:
1418:
277:. Bacteria can acquire resistant genes either by random mutation or through the transfer of DNA from one bacterium to another. Resistance genes interfere with the normal antibiotic function and allow bacteria to grow in the presence of the antibiotic. Resistance in VRSA is conferred by the plasmid-mediated
613:), indicating resistance to all glycopeptide antibiotics. These bacterial strains present a thickening of the cell wall, which is believed to reduce the ability of vancomycin to diffuse into the division septum of the cell required for effective vancomycin treatment.
281:
gene and operon. Although VRSA infections are uncommon, VRSA is often resistant to other types of antibiotics and a potential threat to public health because treatment options are limited. VRSA is resistant to many of the standard drugs used to treat
1175:"Reduced Vancomycin Susceptibility in Staphylococcus aureus, Including Vancomycin-Intermediate and Heterogeneous Vancomycin-Intermediate Strains: Resistance Mechanisms, Laboratory Detection, and Clinical Implications"
1668:
1445:
1592:
Chang, Soju; Sievert, Dawn M.; Hageman, Jeffrey C.; Boulton, Matthew L.; Tenover, Fred C.; Downes, Frances Pouch; Shah, Sandip; Rudrik, James T.; Pupp, Guy R. (April 3, 2003).
897:"Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus Aureus Infections in Adults and Children"
1124:
Chang, Soju; Sievert, Dawn M.; Hageman, Jeffrey C.; Boulton, Matthew L.; Tenover, Fred C.; Downes, Frances Pouch; Shah, Sandip; Rudrik, James T.; Pupp, Guy R. (2003-04-03).
801:
The definition of hVISA according to
Hiramatsu et al. is a strain of Staphylococcus aureus that gives resistance to vancomycin at a frequency of 10 colonies or even higher.
1230:
CLSI (2023). M100 Performance
Standards for Antimicrobial Susceptibility Standards (Report) (33 ed.). Wayne PA: Clinical and Laboratory Standards Institute. p. 8.
38:
391:
332:(VISA), which appear to develop elevated MICs to vancomycin through sequential mutations resulting in a thicker cell wall and the synthesis of excess amounts of
1562:
1335:, including vancomycin-intermediate and heterogeneous vancomycin-intermediate strains: resistance mechanisms, laboratory detection, and clinical implications"
87:
131:
44:
387:
425:, alternative antibiotics should be used. The approach is to treat with at least one agent to which the bacteria known to be susceptible by
738:
452:
383:
2030:
74:
2371:
1970:
298:
was first reported in the United States in 2002. To date, documented cases of VRSA have acquired resistance through uptake of a
2575:
2270:
378:
Resistant or "R" designations are assigned based on agreed upon values called breakpoints. Breakpoints are published by
2406:
1748:
1572:
1455:
1428:
764:
307:
167:
149:
52:
793:
As of 2019, 52 VRSA strains have been identified in the United States, India, Iran, Pakistan, Brazil, and
Portugal.
127:
742:
499:
418:
360:
1173:
Howden, Benjamin P.; Davies, John K.; Johnson, Paul D. R.; Stinear, Timothy P.; Grayson, M. Lindsay (2010-01-01).
2524:
2396:
1830:
372:
479:
1717:
2376:
200:
2570:
2020:
1514:"Vancomycin resistant Staphylococcus aureus infections: A review of case updating and clinical features"
1069:"Vancomycin resistant Staphylococcus aureus infections: A review of case updating and clinical features"
2565:
2000:
2429:
756:
462:
in the setting of vancomycin failure the
Infectious Diseases Society of America recommends high-dose
448:
375:. Once the MIC is known, resistance is determined by comparing the MIC with established breakpoints
1282:"Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility"
2221:
2143:
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1818:
1680:
663:
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2175:
333:
271:
79:
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1126:"Infection with Vancomycin-Resistant Staphylococcus aureus Containing the vanA Resistance Gene"
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2182:
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936:
658:
621:
266:
209:
1241:
Appelbaum PC (November 2007). "Reduced glycopeptide susceptibility in methicillin-resistant
2464:
2424:
2291:
2105:
2100:
2080:
2015:
1867:
962:"Editorial: Genetics of Acquired Antimicrobial Resistance in Animal and Zoonotic Pathogens"
8:
2544:
2486:
2469:
2128:
1845:
1672:
444:
364:
1707:
1280:
Hiramatsu, K.; Hanaki, H.; Ino, T.; Yabuta, K.; Oguri, T.; Tenover, F. C. (1997-07-01).
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infections. Furthermore, resistance can be transferred from one bacterium to another.
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experiments reported in 1992 demonstrated that vancomycin resistance genes from
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359:
isolate to vancomycin. This is accomplished by first assessing the isolate's
192:
851:
2454:
2439:
2265:
1990:
1840:
1825:
1771:
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1498:
1403:
1368:
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1281:
1266:
1216:
1159:
1110:
1053:
1005:
922:
878:
747:
1315:
796:
466:, if the isolate is susceptible, in combination with another agent (e.g.,
2313:
2258:
2155:
2010:
1985:
1803:
1614:
1593:
1350:
1190:
1142:
1125:
913:
896:
835:"Methicillin and Vancomycin Resistant S. aureus in Hospitalized Patients"
1660:
483:
2401:
2286:
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2025:
1975:
1960:
1955:
1948:
1933:
1923:
1645:
1420:
Bacterial Toxins: Genetics, Cellular
Biology and Practical Applications
775:
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616:
2474:
2216:
2211:
2075:
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1928:
1892:
1329:
Howden BP, Davies JK, Johnson PD, Stinear TP, Grayson ML (Jan 2010).
1026:
McGuinness, Will A.; Malachowa, Natalia; DeLeo, Frank (23 Jun 2017).
733:) was isolated from a patient in Michigan. The isolate contained the
475:
436:
355:(VRSA) is performed by performing susceptibility testing on a single
960:
Cloeckaert, Axel; Zygmunt, Michel S.; Doublet, Benoît (2017-12-05).
1980:
1757:
1489:
1472:
1382:
Gould IM (December 2010). "VRSA-doomsday superbug or damp squib?".
833:
Loomba, Poonam Sood; Taneja, Juhi; Mishra, Bibhabati (2010-01-01).
646:
427:
326:
214:
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of the VRSA isolate were consistent with the VanA phenotype of
674:. Until 2002 such a genetic transfer was not reported for wild
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713:
565:
542:
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368:
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690:
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in 1996 and has since been found in hospitals elsewhere in
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571:
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548:
517:
1591:
1328:
1172:
1123:
1067:
Cong, Yanguang; Yang, Sijin; Rao, Xiancai (January 2020).
392:
European
Committee on Antimicrobial Susceptibility Testing
1279:
1025:
959:
631:
797:
Heterogeneous vancomycin-intermediate S. aureus (hVISA)
373:
automated antimicrobial susceptibility testing systems
1561:
Lu, Yichen; Essex, Max; Roberts, Bryan (2008-04-11).
722:
693:
574:
545:
1650:
710:
687:
609:. It is also termed GISA (glycopeptide-intermediate
562:
539:
684:
536:
289:
122:
may be too technical for most readers to understand
1512:Cong, Yanguang; Yang, Sijin; Rao, Xiancai (2020).
832:
670:, conferring high-level vancomycin resistance to
2557:
1028:"Vancomycin Resistance in Staphylococcus aureus"
937:"CDC - VISA / VRSA in Healthcare Settings - HAI"
782:carried by the VRSA isolate. This transposon, Tn
1560:
1473:"Vancomycin resistance in gram-positive cocci"
1443:
506:(VISA), heterogeneous vancomycin-intermediate
388:British Society for Antimicrobial Chemotherapy
1742:
510:(hVISA), and high-level vancomycin-resistant
363:using standard laboratory methods, including
1464:
1375:
1240:
1234:
790:-type vancomycin resistance in enterococci.
774:gene was later found to be encoded within a
1511:
1470:
1066:
384:Clinical and Laboratory Standards Institute
310:). The acquired mechanism is typically the
53:Learn how and when to remove these messages
2031:Reproductive endocrinology and infertility
1749:
1735:
1718:Vancomycin-resistant Staphylococcus aureus
770:recovered from the same catheter tip. The
431:testing. The agents that are used include
191:
186:Vancomycin-resistant Staphylococcus aureus
2372:Bachelor of Medicine, Bachelor of Surgery
1613:
1567:. Springer Science & Business Media.
1537:
1488:
1358:
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1043:
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868:
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168:Learn how and when to remove this message
150:Learn how and when to remove this message
134:, without removing the technical details.
1381:
615:
401:
90:of all important aspects of the article.
498:have emerged that differ in vancomycin
325:This mechanism differs from strains of
248:Beta-lactam antibiotic (in combination)
2558:
1331:"Reduced vancomycin susceptibility in
890:
888:
494:Three classes of vancomycin-resistant
361:minimum inhibitory concentration (MIC)
351:The diagnosis of vancomycin-resistant
86:Please consider expanding the lead to
1730:
1594:"Infection with Vancomycin-Resistant
1416:
1286:Journal of Antimicrobial Chemotherapy
839:Journal of Global Infectious Diseases
828:
826:
270:that have acquired resistance to the
132:make it understandable to non-experts
2510:
2271:Physical medicine and rehabilitation
1598:Containing the vanA Resistance Gene"
1447:Antimicrobial Resistance in Bacteria
1229:
1021:
1019:
1017:
1015:
895:Liu, Catherine; et al. (2011).
640:High-level vancomycin resistance in
106:
59:
18:
2520:
894:
885:
380:standards development organizations
13:
2407:Medical Scientist Training Program
1585:
1444:Amábile-Cuevas, Carlos F. (2007).
823:
314:gene and operon from a plasmid in
14:
2592:
1639:
1259:10.1016/j.ijantimicag.2007.07.011
1012:
751:species, and the presence of the
678:strains. In 2002, a VRSA strain (
34:This article has multiple issues.
2539:
2529:
2519:
2509:
2500:
2499:
1700:
763:gene was identical to that of a
706:
680:
558:
532:
419:minimum inhibitory concentration
290:Mechanism of acquired resistance
111:
64:
23:
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1602:New England Journal of Medicine
1554:
1505:
1437:
1410:
1322:
1273:
1130:New England Journal of Medicine
765:vancomycin-resistant strain of
759:. The DNA sequence of the VRSA
78:may be too short to adequately
42:or discuss these issues on the
2397:Doctor of Osteopathic Medicine
1831:Oral and maxillofacial surgery
1223:
1166:
1117:
1060:
953:
929:
88:provide an accessible overview
16:Antibiotica resistant bacteria
1:
2576:Antibiotic-resistant bacteria
1396:10.1016/S1473-3099(10)70259-0
1179:Clinical Microbiology Reviews
816:
480:trimethoprim/sulfamethoxazole
302:resistance gene cluster from
2377:Bachelor of Medical Sciences
2144:Neurosurgical anesthesiology
1756:
1471:Courvalin P (January 2006).
1450:. Horizon Scientific Press.
1423:. Horizon Scientific Press.
1073:Journal of Advanced Research
901:Clinical Infectious Diseases
346:
201:Scanning electron micrograph
7:
1564:Emerging Infections in Asia
804:
10:
2597:
1530:10.1016/j.jare.2019.10.005
1247:Int. J. Antimicrob. Agents
1085:10.1016/j.jare.2019.10.005
644:has been rarely reported.
585:) was first identified in
502:: vancomycin-intermediate
489:
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2116:
2044:
1999:
1908:
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966:Frontiers in Microbiology
757:polymerase chain reaction
449:quinupristin–dalfopristin
244:
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224:
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185:
2331:Transplantation medicine
2222:Clinical neurophysiology
2139:Obstetric anesthesiology
2059:Interventional radiology
1819:Digestive system surgery
979:10.3389/fmicb.2017.02428
662:could be transferred by
526:Vancomycin-intermediate
518:Vancomycin-intermediate
369:gradient strip diffusion
327:vancomycin-intermediate
215:vancomycin-intermediate
2202:Intensive care medicine
2176:Mass gathering medicine
2021:Maternal–fetal medicine
852:10.4103/0974-777X.68535
272:glycopeptide antibiotic
1794:Cardiothoracic surgery
1417:Proft, Thomas (2013).
755:gene was confirmed by
739:methicillin resistance
628:
453:methicillin-resistant
414:
398:Treatment of infection
213:bacteria taken from a
2445:Personalized medicine
2304:Reproductive medicine
2229:Occupational medicine
2183:Evolutionary medicine
1596:Staphylococcus aureus
1333:Staphylococcus aureus
1243:Staphylococcus aureus
767:Enterococcus faecalis
659:Enterococcus faecalis
632:Vancomycin-resistant
619:
611:Staphylococcus aureus
455:Staphylococcus aureus
405:
353:Staphylococcus aureus
329:Staphylococcus aureus
320:Enterococcus faecalis
296:Staphylococcus aureus
294:Vancomycin-resistant
267:Staphylococcus aureus
257:Staphylococcus aureus
255:Vancomycin-resistant
217:Staphylococcus aureus
210:Staphylococcus aureus
2465:Traditional medicine
2425:Alternative medicine
2292:Addiction psychiatry
2106:Transfusion medicine
2101:Medical microbiology
2016:Gynecologic oncology
1868:Reproductive surgery
1615:10.1056/NEJMoa025025
1351:10.1128/CMR.00042-09
1339:Clin. Microbiol. Rev
1299:10.1093/jac/40.1.135
1191:10.1128/CMR.00042-09
1143:10.1056/NEJMoa025025
316:Enterococcus faecium
2487:History of medicine
2470:Veterinary medicine
2277:Preventive medicine
2129:Adolescent medicine
1971:Infectious diseases
1483:(Suppl 1): S25–34.
2571:Bacterial diseases
2435:Molecular oncology
2392:Doctor of Medicine
2382:Master of Medicine
2299:Radiation oncology
2171:Emergency medicine
2124:Addiction medicine
2091:Clinical chemistry
2086:Clinical pathology
1878:Transplant surgery
1836:Orthopedic surgery
1814:Colorectal surgery
914:10.1093/cid/ciq146
629:
595:the United Kingdom
451:. For people with
415:
2566:Staphylococcaceae
2553:
2552:
2387:Master of Surgery
2351:
2350:
2336:Tropical medicine
2282:Prison healthcare
2197:Hospital medicine
2161:Disaster medicine
2151:Aviation medicine
1966:Hospital medicine
1873:Surgical oncology
1858:Pediatric surgery
1852:
1799:Endocrine surgery
1695:
1694:
1608:(14): 1342–1347.
1477:Clin. Infect. Dis
1384:Lancet Infect Dis
1136:(14): 1342–1347.
421:of vancomycin is
382:such as the U.S.
340:
336:
264:) are strains of
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236:Diagnostic method
180:Medical condition
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2207:Medical genetics
2192:General practice
2069:Nuclear medicine
1944:Gastroenterology
1900:Vascular surgery
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2480:Chief physician
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2341:Travel medicine
2326:Sports medicine
2309:Sexual medicine
2249:Palliative care
2244:Pain management
2188:Family medicine
2166:Diving medicine
2112:
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2002:
1995:
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1863:Plastic surgery
1809:General surgery
1789:Cardiac surgery
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1586:Further reading
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220:(VISA) culture.
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1826:Neurosurgery
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2525:Wikiproject
2314:Venereology
2259:Neonatology
2156:Dermatology
2011:Gynaecology
2003:gynaecology
1986:Pulmonology
1804:Eye surgery
1766:Specialties
1524:: 169–176.
1079:: 169–176.
941:www.cdc.gov
484:beta-lactam
445:ceftaroline
2560:Categories
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2273:(PM&R)
2266:Phlebology
2254:Pediatrics
2081:Anatomical
2046:Diagnostic
2026:Obstetrics
1976:Nephrology
1961:Hematology
1956:Geriatrics
1949:Hepatology
1934:Cardiology
1924:Immunology
1686:D000083123
946:2015-06-11
817:References
786:, confers
776:transposon
626:blood agar
468:gentamicin
464:daptomycin
460:bacteremia
441:telavancin
433:daptomycin
407:Rifampicin
343:residues.
300:vancomycin
275:vancomycin
39:improve it
2475:Physician
2359:education
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2212:Narcology
2076:Pathology
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476:linezolid
437:linezolid
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347:Diagnosis
284:S. aureus
245:Treatment
226:Specialty
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