Isolation in Brazil of Nosocomial<i>Staphylococcus aureus</i>With Reduced Susceptibility to Vancomycin

Oliveira, G. A.; Dell’Aquila, Adriana; Masiero, Rita L.; Levy, Carlos Emílio; Gomes, Marcia S.; Cui, Longzhu; Hiramatsu, Kazumasa; Mamizuka, Elsa Masae

doi:10.1086/501932

Cited by 84 publications

(77 citation statements)

References 32 publications

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“…The finding of type IV SCCmec in nosocomial strains in Brazil should be, like the emergence of VISA [27], of great concern to the medical community. CA-MRSA is emerging as significant community pathogens, especially in previously healthy children who bear no recognizable risk factors.…”

Section: Discussionmentioning

confidence: 99%

Type IV SCCmec found in decade old Brazilian MRSA isolates

Reinert

McCulloch

Watanabe³

et al. 2008

Braz J Infect Dis

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Section: Discussionmentioning

confidence: 99%

Type IV SCCmec found in decade old Brazilian MRSA isolates

Reinert

McCulloch

Watanabe³

et al. 2008

Braz J Infect Dis

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“…However, the interest on the acquisition of resistance to glycopeptides increased only after the isolation of Staphylococcus aureus strains presenting intermediate resistance to vancomycin (VISA strains) worldwide [4,5]. Studies with VISA isolates from several countries indicated that these strains present resistance to low levels of vancomycin (minimal inhibitory concentration [MIC] of 8 μg/mL) that is not associated with the presence of van genes responsible for resistance to glycopeptides in enterococci [1,5,6].…”

mentioning

confidence: 99%

Heterogeneous resistance to vancomycin and teicoplanin among Staphylococcus spp. isolated from bacteremia

Nunes

Schuenck

Bastos³

et al. 2007

Braz J Infect Dis

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This study evaluated the BHIA screening method with 4 or 6 μ μ μ μ μg/mL of vancomycin to detect glycopeptides heteroresistant staphylococci strains isolated from bacteremia. A total of 213 staphylococci strains were isolated from 106 patients between October/2001 and November/2002 in a tertiary hospital in Rio de Janeiro city. Fifty-seven (53.8%) patients presented Staphylococcus aureus, while coagulase-negative staphylococci (CNS) were isolated from 49 (46.2%). Resistance rates for oxacillin of 26.3% and 81.6% were found for the staphylococci isolates, respectively. Thirteen CNS isolated from nine (8.5%) patients grew on agar screening with 4 μ μ μ μ μg/mL of vancomycin and showed heterogeneous profiles of resistance for vancomycin and teicoplanin by the population analysis profile method. Only 30.8% of them grew at the concentration 6 μ μ μ μ μg/mL. Bacterial infection and use of antimicrobial therapy were common among these patients. Alert about the emergence of oxacillin-resistant staphylococci presenting heteroresistance to glycopeptides is important in order to achieve judicious use of antimicrobials. Vancomycin agar screening test could help to confirm the presence of these isolates in hospitals.

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“…La cepa MRSA aislada, denominada Mu50, tenía una CIM para vancomicina de 8 µg/ml determinada por microdilución en caldo. Desde entonces se han reportado cepas VISA en Europa (18,19), Estados Unidos (20)(21)(22)(23), Asia (24) y Brasil (25). El grupo colombiano de resistencia antimicrobiana, RESCOL (26), tras analizar 296 aislamientos nosocomiales de S.aureus en el período 2001-2002 encontró 52% de resistencia a meticilina, pero ninguna cepa VISA mediante la técnica de tamizaje en agar infusión cerebro corazón (BHIA, Brain-Heart infusion Agar) con 6 µg/ml de vancomicina según recomendación del CLSI y de los Centers for Disease Control (CDC) (27).…”

Section: Resistencia Intermedia a Vancomicina: Cepas Visaunclassified

Staphylococcus aureus resistente a vancomicina.

Rodríguez¹,

Vesga

2005

biomedica

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Objetivo. Revisar la evolución y mecanismos moleculares de la resistencia de Staphylococcus aureus a vancomicina. Fuente de los datos. Se consultó la base de datos MEDLINE y se seleccionaron artículos tipo reportes de caso, estudios bioquímicos, de microscopía electrónica y biología molecular pertinentes. Síntesis. Después de casi 40 años de eficacia ininterrumpida de la vancomicina, en 1997 se reportaron los primeros casos de fracaso terapéutico debido a cepas de Staphylococcus aureus con resistencia intermedia, denominadas VISA (concentración inhibitoria mínima, CIM, 8 a 16 µg/ml), así como a cepas con resistencia heterogénea hVISA (CIM global = 4 µg/ml, pero con subpoblaciones VISA), en las cuales la resistencia está mediada por engrosamiento de la pared celular y disminución de su entrecruzamiento, lo que afecta la llegada del antibiótico al blanco principal, los monómeros del peptidoglicano en la membrana plasmática. En 2002 se aisló la primera de las 3 cepas reportadas hasta la fecha con resistencia total al antibiótico, denominadas VRSA (CIM>32 µg/ml), en las que se encontró el transposón Tn1546 proveniente de Enterococcus spp, responsable del reemplazo de la terminación D-Ala-D-Ala por D-Ala-Dlactato en los precursores de la pared celular con pérdida de la afinidad por el glicopéptido. Conclusiones. La resistencia a vancomicina es una realidad en S. aureus, mediada en el caso de VISA por alteraciones en la pared celular que atrapan el antibiótico antes de llegar al sitio de acción, y en el caso de VRSA, por transferencia desde Enterococcus spp. de genes que llevan a la modificación del blanco molecular.Palabras clave: Staphylococcus aureus, peptidoglicano, biosíntesis, antibióticos glicopéptidos, vancomicina, resistencia microbiana a drogas, resistencia a vancomicina. Vancomycin-resistant Staphylococcus aureusThe evolution and molecular mechanisms of vancomycin resistance in Staphylococcus aureus were reviewed. Case reports and research studies on biochemestry, electron microscopy and molecular biology of Staphylococcus aureus were selected from Medline database and summarized in the following review. After almost 40 years of successful treatment of S. aureus with vancomycin, several cases of clinical failures have been reported (since 1997). S. aureus strains have appeared with intermediate susceptibility (MIC 8-16 µg/ml), as well as strains with heterogeneous resistance (global MIC ≤ 4 µg/ml), but with subpopulations of intermediate susceptibility. In these cases, resistance is mediated by cell wall thickening with reduced cross linking. This traps the antibiotic before it reaches its major target, the murein monomers in the cell membrane. In 2002, a total vancomycin resistant strain (MIC ≥ 32 µg/ml) was reported with vanA genes from Enterococcus spp. These genes induce the change of D-Ala-D-Ala terminus for D-Ala-D-lactate in the cell wall precursors, leading to loss of affinity for glycopeptides. Vancomycin resistance in S. aureus has appeared; it is mediated by cell wall modifications that trap the ...

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Isolation in Brazil of NosocomialStaphylococcus aureusWith Reduced Susceptibility to Vancomycin

Cited by 84 publications

References 32 publications

Type IV SCCmec found in decade old Brazilian MRSA isolates

Type IV SCCmec found in decade old Brazilian MRSA isolates

Heterogeneous resistance to vancomycin and teicoplanin among Staphylococcus spp. isolated from bacteremia

Staphylococcus aureus resistente a vancomicina.

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