The Development of Vancomycin Resistance in a Patient with Methicillin-Resistant<i>Staphylococcus aureus</i>Infection

Sieradzki, Krzysztof; Roberts, Richard B.; Haber, Stuart W.; Tomasz, Alexander

doi:10.1056/nejm199902183400704

Cited by 583 publications

(396 citation statements)

References 12 publications

Supporting

Mentioning

367

Contrasting

Unclassified

Order By: Relevance

“…2 Treatment of methicillin resistant S. aureus (MRSA) with vancomycin and increased empirical use of this antibiotic provided the antibiotic pressure associated with the emergence of vancomycin resistant enterococci and vancomycin intermediate resistant staphylococci. 3 For other pathogens, resistance took longer to emerge. For example pneumococcal penicillin resistance was first observed only in the 1960s and subsequently spread globally due to continual changes to the antibiotic target, the bacterial penicillin binding proteins.…”

Section: Amr Is An Urgent Health Threat and Large Economic Problemmentioning

confidence: 99%

The role of vaccines in fighting antimicrobial resistance (AMR)

Jansen

Anderson

2018

Human Vaccines & Immunotherapeutics

104

View full text Add to dashboard Cite

The problem of antimicrobial resistance (AMR) and the associated morbidity and mortality due to antibiotic resistant bacterial pathogens is not new. However, AMR has been increasing at an alarming rate with appearances of diseases caused by bacteria exhibiting resistance to not just one but multiple classes of antibiotics. The World Health Organization (WHO) supported by governments, health ministries and health agencies has formulated global action plans to combat the rise in AMR, supporting a number of proven initiatives such as antimicrobial stewardship, investments in development of new classes of antibiotics, and educational programs designed to eliminate inappropriate antibiotic use. Vaccines as tools to reduce AMR have historically been under-recognized, yet the positive effect in reducing AMR has been well established. For example Haemophilus influenzae type B (Hib) as well as Streptococcus pneumoniae (pneumococcal) conjugate vaccines have impressive track records in not only preventing life threatening diseases caused by these bacteria, but also reducing antibiotic use and AMR. This paper will describe the drivers of antibiotic use and subsequent development of AMR; it will make the case how existing vaccines are already participating in combatting AMR, describe future prospects for the role of new vaccines in development to reduce AMR, and highlight challenges associated with future vaccine development to combat AMR.

show abstract

Section: Amr Is An Urgent Health Threat and Large Economic Problemmentioning

confidence: 99%

The role of vaccines in fighting antimicrobial resistance (AMR)

Jansen

Anderson

2018

Human Vaccines & Immunotherapeutics

104

View full text Add to dashboard Cite

show abstract

“…It is known that unnecessary use of glycopeptide antibiotics contributes to the development of glycopeptide resistant Gram-positive organisms (Sieradzki et al 1999;Carratala 2002;Oncu et al 2004). Infections due to these resistant organisms are diffucult to treat, and there is increased morbidity and mortality with these type of infections.…”

Section: Discussionmentioning

confidence: 99%

Elimination of Intraluminal Colonization by Antibiotic Lock in Catheters

Öncü

Öztürk

et al. 2004

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

Antibiotic lock (AL) technique for catheter related infection encompasses the filling of a catheter lumen with high concentrations of antibiotics for hours. The goal of AL therapy is to decontaminate the intraluminal surface of the catheter. However the duration of antibiotic therapy is not established. An in vitro model was designed to establish the time needed to eliminate intraluminal microbial colonization and to evaluate the efficacy of vancomycin in comparison with teicoplanin by using laboratory AL model. Human plasma was instilled into the catheters to allow deposition of fibrin and other products on the catheter wall. After 48 hours, the catheters were drained and inoculated with bacteria in tryptic soy broth. The catheters were then drained and filled with either (a) vancomycin saline solution (VSS) lock (b) teicoplanin saline solution (TSS) lock or (c) saline solution (SS) as the control and then incubated for 12 hours. After 12 hours incubation all the catheter were drained and filled with human plasma. Instillation of human plasma and AL was alternated every 12 hours to simulate clinical conditions. For each day three catheters, locked with VSS, TSS and SS were cultured for colony count. Microbial counts were expressed as total colony-forming units per longitudinal centimeters of catheter surface. A significant decrease in intraluminal catheter colonization started as early as day 1. At the end of 7th day catheters treated with VSS and TSS lock were completely sterile. The decrease of intraluminal colonization was similar in catheters treated with VSS and TSS lock. Also the decrease of intraluminal colonization were similar in catheter colonized with slime forming S. epidermidis and nonslime-forming S. epidermidis. antibiotic lock; catheter; teicoplanin; vancomycin

show abstract

“…Vancomycin binds to the peptidoglycan precursor and then inhibits the incorporation of newly synthesized precursors in the cell wall peptidoglycan, thus causing inhibition of cell wall synthesis. Recently, vancomycin-intermediate susceptible S. aureus (VISA), or glycopeptide-intermediate susceptible S. aureus (GISA), emerged [27][28][29][30][31], followed in the USA by a vancomycin-resistant S. aureus (VRSA) [32,33]. The mechanism of vancomycin resistance in the VRSA is due to expression of the vanA gene, which modifies the structure of the peptidoglycan, causing a loss of affinity of vancomycin for the peptidoglycan precursor [34].…”

Section: S Aureus Develops Resistance To Chemotherapeutic Agents; Thmentioning

confidence: 99%

Innate defences against methicillin‐resistant Staphylococcus aureus (MRSA) infection

Komatsuzawa

Ouhara

Yamada

et al. 2005

The Journal of Pathology

View full text Add to dashboard Cite

The innate immune system is the primary defence against bacterial infection. Among the factors involved in innate defence, anti-microbial peptides produced by humans have recently attracted attention due to their relevance to some diseases and also to the development of new chemotherapeutic agents. Staphylococcus aureus is one of the major human pathogens, causing a variety of infections from suppurative disease to food poisoning. Methicillin-resistant S. aureus (MRSA) is a clinical problem and with the recent emergence of a vancomycin-resistant strain, this will pose serious problems in the near future. In investigating the molecular biology of S. aureus infections to develop new chemotherapeutic agents against MRSA infections, knowledge of the interaction of innate anti-microbial peptides with S. aureus is important. In vitro and in vivo experiments demonstrate that exposure of S. aureus to host cells can induce the anti-microbial peptides β-defensin-2 (hBD2), hBD3, and LL37/CAP18. The induction level of these peptides differs among strains, as does the susceptibility of the strains, with MRSA strains exhibiting lower susceptibility. In summary, the susceptibility of S. aureus strains, including MRSA strains, to components of the innate immune system varies, with the MRSA strains showing more resistance to both innate immune factors and chemotherapeutic agents.

show abstract

The Development of Vancomycin Resistance in a Patient with Methicillin-ResistantStaphylococcus aureusInfection

Cited by 583 publications

References 12 publications

The role of vaccines in fighting antimicrobial resistance (AMR)

The role of vaccines in fighting antimicrobial resistance (AMR)

Elimination of Intraluminal Colonization by Antibiotic Lock in Catheters

Innate defences against methicillin‐resistant Staphylococcus aureus (MRSA) infection

Contact Info

Product

Resources

About