Vancomycin-Resistant<i>Staphylococcus aureus,</i>Michigan, USA, 2007

Finks, Jennie; Wells, Eden V.; Dyke, Teri Lee; Husain, N.; Plizga, Linda; Heddurshetti, Renuka; Wilkins, Melinda J.; Rudrik, James T.; Hageman, Jeffrey; Patel, Jean B.; Miller, Corinne E.

doi:10.3201/eid1506.081312

Cited by 74 publications

(45 citation statements)

References 7 publications

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“…He finally died after respiratory distress. The patient conditions were in agreement with previous findings about VRSA infections (14,33). The isolated strain had a vancomycin MIC of 512 g/ml, consistent with other reported VRSA strains that had vancomycin MICs in the range of 32 to 1,024 g/ml (2).…”

Section: Discussionsupporting

confidence: 81%

“…So far, other isolated VRSA strains show relatively high degrees of plasmid profile differences in comparison to our strain (14,15,29,40). By comparing the restriction profile of our plasmids with other reported profiles, we suppose that our profile has more similarity with staphylococcal plasmid profiles than with enterococcal ones even though further experiments are required to elucidate the matter (14,15,29,40).…”

Section: Discussionmentioning

confidence: 89%

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Genetic Characterization of a Vancomycin-Resistant Staphylococcus aureus Isolate from the Respiratory Tract of a Patient in a University Hospital in Northeastern Iran

et al. 2012

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Emergence of vancomycin-intermediate Staphylococcus aureus (VISA) and vancomycin-resistant S. aureus (VRSA) strains has led to global concerns about treatments for staphylococcal infections. These strains are currently rare even though there is an upward trend in their reported incidence. Therefore, appropriate screening and epidemiological evaluation of VRSA strains can affect future global health care policies. Isolates of Staphylococcus aureus were obtained from various clinical samples and were then evaluated with agar screening, disk diffusion, and MIC methods to determine resistance to vancomycin and methicillin. After confirmation of the isolated VRSA strain, genetic analysis was performed by evaluating mecA and vanA gene presence, SCCmec, agr, and spa types, and toxin profiles. Multilocus sequence typing (MLST) and plasmid analysis were also performed. The VRSA strain was resistant to oxacillin (MIC of 128 g/ml) and vancomycin (MIC of 512 g/ml). Disk diffusion antimicrobial susceptibility tests showed resistance to oxacillin, vancomycin, levofloxacin, ciprofloxacin, trimethoprim-sulfamethoxazole, clindamycin, rifampin, and tetracycline. The isolate was susceptible to minocycline and gentamicin. PCRs were positive for the mecA and vanA genes. Other genetic characteristics include SCCmec type III, agr I, spa type t037, and sequence type (ST) 1283. The plasmid profile shows five plasmids with a size of ϳ1.7 kb to >10 kb. The isolated VRSA strain was obtained from a critically ill hospitalized patient. Genetic analysis of this strain suggested that the strain was a methicillin-resistant S. aureus (MRSA) clone endemic in Asia that underwent some genetic changes, such as mutation in the gmk gene and acquisition of the vanA gene.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 89%

Genetic Characterization of a Vancomycin-Resistant Staphylococcus aureus Isolate from the Respiratory Tract of a Patient in a University Hospital in Northeastern Iran

et al. 2012

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“…The first clinical vanA-mediated high-level vancomycinresistant MRSA (VRSA) was isolated from a dialysis patient in Michigan, USA (Weigel et al, 2003;Chang et al, 2003). Since then, less than a dozen additional cases have been described, nine in the United States (Michigan [n= 7], New York and Pennsylvania) and each one in India and in Iran (the latter two were not confirmed elsewhere) (Sievert et al, 2008;Finks et al, 2009;Nannini et al, 2010).…”

Section: The Vana Gene Cluster In Staphylococcus Aureusmentioning

confidence: 99%

Current Trends of Emergence and Spread of Vancomycin-Resistant Enterococci

Werner¹

2012

Antibiotic Resistant Bacteria - A Continuous Challenge in the New Millennium

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“…Thus, cocolonization with MRSA and VRE is necessary for vanA transfer and subsequent emergence of VRSA. Indeed, several of the VRSA cases had documented coinfection with VRE at the time of VRSA isolation [1,5]. Therefore, because MRSA/VRE cocolonization precedes VRSA emergence, we chose to investigate the incidence of MRSA/VRE cocolonization in skilled nursing facilities (SNFs), a long-stay population.…”

mentioning

confidence: 99%

Wounds, Functional Disability, and Indwelling Devices Are Associated With Cocolonization by Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococci in Southeast Michigan

Flannery

Wang²,

Zöllner

et al. 2011

Clinical Infectious Diseases

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Background. Methicillin-resistant Staphylococcus aureus (MRSA) remains sensitive to vancomycin; when vancomycin-resistant S. aureus (VRSA) emerges, treatment becomes more complex. VRSA emergence is attributed to conjugative transfer of the vancomycin-resistance gene cluster from vancomycin-resistant enterococci (VRE) to MRSA. Because cocolonization with MRSA and VRE precedes VRSA development, this study investigates the epidemiology of cocolonization in skilled nursing facility (SNF) residents at high risk for MRSA or VRE colonization.Methods. A prospective observational study conducted at 15 SNFs in southeast Michigan. Overall, 178 residents (90 with indwelling urinary catheters and/or feeding tubes and 88 device-free) were cultured monthly for MRSA and VRE, and clinical data were recorded.Results. The incidence of MRSA/VRE cocolonization among residents with indwelling devices was 6.5 per 100 resident-months; 5.2 (95% confidence interval [CI]: 1.49-18.1) times that among those without devices. MRSA/ VRE cocolonization in the device group occurred most frequently in wounds (4.1 per 100 resident-months). In a logistic regression analysis limited to residents with devices, functional disability (rate ratio [RR], 1.3; 95% CI: 1.1-1.4) and wound presence (RR, 3.4; 95% CI: 1.4-8.6) were independent risk factors of cocolonization.Conclusions. In a population of SNF residents, individuals with indwelling devices who also had functional disability or wounds were at greatest risk of MRSA/VRE cocolonization. These individuals should be routinely monitored for the presence of VRSA colonization.

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Vancomycin-ResistantStaphylococcus aureus,Michigan, USA, 2007

Cited by 74 publications

References 7 publications

Genetic Characterization of a Vancomycin-Resistant Staphylococcus aureus Isolate from the Respiratory Tract of a Patient in a University Hospital in Northeastern Iran

Genetic Characterization of a Vancomycin-Resistant Staphylococcus aureus Isolate from the Respiratory Tract of a Patient in a University Hospital in Northeastern Iran

Current Trends of Emergence and Spread of Vancomycin-Resistant Enterococci

Wounds, Functional Disability, and Indwelling Devices Are Associated With Cocolonization by Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococci in Southeast Michigan

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