Reports of Vancomycin-Resistant Staphylococcus aureus from Middle East Countries

Abstract

Context: Staphylococcus aureus is one of the most important pathogens worldwide. The emergence of methicillin-resistant Staphylococcusaureus (MRSA) made vancomycin as the only therapeutic choice. Due to excessive use of vancomycin, decreased susceptibility and increased resistance against this antibiotic are reported worldwide. The current study aimed at investigating the emergence of vancomycin-resistant Staphylococcus aureus (VRSA) in different regions of the Middle-East. Evidence Acquisition: All reputable databases, such as Google Scholar and PubMed, were screened for articles and abstracts reporting VRSA in the Middle-East by the appropriate keywords. Reliable phenotypic and genotypic studies were included in the current review. Results: Reviewing all articles/abstracts revealed more than 100 reports of VRSA isolates from the Middle-East. Most of the studies did not use the clinical and laboratory standards institute (CLSI) guidelines on VRSA identification. Until 2012, four VRSA strains were reported from Iran, 7 from Egypt, and 1 from Pakistan. From 2012 to 2016, seven VRSA isolates were added to the global statistics from the Middle-East; 1 from Iran and 6 from Egypt. Conclusions: VRSA is a global health threat. According to the expanding reports on the emersion of VRSA, more attention should be paid to the proper prescription of this antibiotic as the only choice for S. aureus infections.

ECOLOGY OF Staphylococcus aureus AND ITS ANTIBIOTIC RE-SISTANCE GENES IN DAIRY FARMS: CONTRIBUTING FACTORS AND PUBLIC HEALTH IMPLICATIONS

“…In last few years, a new resistance genotype assigned as vancomycin resistant S. aureus (VRSA) has emerged when a MRSA isolate gained vanA gene and expressed resistance to vancomycin in a clinical case (7).Humans' clinical reports of VRSA infection are expanding in the Middle East, particularly in Egypt (8). However, dairy farm associated VRSA was never recorded in Egypt and also very limited data are available worldwide (9).…”

Characterization of Virulence Factors and Prophage Profiles of Methicillin-Resistant Staphylococcus aureus Strains Isolated from a Referral Hospital in Tehran, Iran

“…S. aureus is responsible for a variety of diseases, from mild skin infections such as abscesses and postsurgical wound infections to severe life-threatening respiratory infections such as sinusitis (1,2). During the years, these bacteria have been known as one of the most common causes of hospital-acquired (HA) infections, which can acquire resistance to a variety of antibiotics such as oxacillin and vancomycin that enable them to be present and persist in hospitals and communities in different geographical regions worldwide (3,4).…”

Clinical and Pharmacokinetic Outcomes of Peak–Trough-Based Versus Trough-Based Vancomycin Therapeutic Drug Monitoring Approaches: A Pragmatic Randomized Controlled Trial

“…The use of vancomycin in the treatment of serious Gram-positive infections has become very challenging in Asia, including the Middle East and North Africa (MENA) region [16, 26, 27]. A meta-analysis of 91 studies exploring the epidemiology of vancomycin intermediate-resistant S.aureus (VISA) strains during 1997 and 2014, reported higher VISA incidence rates in Asia, including MENA, compared to other regions [26].…”

“…A meta-analysis of 91 studies exploring the epidemiology of vancomycin intermediate-resistant S.aureus (VISA) strains during 1997 and 2014, reported higher VISA incidence rates in Asia, including MENA, compared to other regions [26]. Given that suboptimal antimicrobial therapy of MRSA contributes to the emergence of resistant strains [27], these findings highlight the potentially high prevalence of inadequate vancomycin treatment in MENA. This can be attributed to non-adherence to clinical practice guidelines or the limited generalizability of vancomycin AUC 24 /MIC targets reported elsewhere.…”