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Emergence of Staphylococcus aureus with Reduced Susceptibility to Vancomycin in Asia

  • Jae-Hoon Song

Staphylococcus aureus is one of the most important bacterial pathogens causing various infections from mild skin and skin structure infections to potentially fatal systemic illnesses such as endocarditis and sepsis. S. aureus has developed antimicrobial resistance to various antibiotics since the introduction of modern chemotherapeutic agents in the 1940s. Particularly, the emergence and dissemination of methicillin-resistant S. aureus (MRSA) has become a global concern since the first report in 1961. Nowadays, MRSA is the most common nosocomial pathogen in many hospitals. MRSA is also emerging in the community in many countries in recent years. The high rate of MRSA infections has led to an increasing use of vancomycin in clinical practice during the past two decades. Since the early 1990s, there have been some concern about the emergence of S. aureus with reduced susceptibility to vancomycin, as vancomycin-resistant enterococci (VRE) has rapidly emerged in many countries. Furthermore, conjugative transfer of the vanA gene from VRE to S. aureus was demonstrated in the laboratory (Noble et al., 1992). This theoretical concern became a reality in 1996 when the first strain of S. aureus with intermediate resistance to vancomycin was found from a 4-month-old infant patient who underwent open heart surgery in Japan (Hiramatsu et al., 1997). Subsequently, infections with vancomycin-intermediate S. aureus (VISA) strains have been reported in patients from the United States, Europe, and Asia.

Growing concern of vancomycin resistance in S. aureus was deepened by the emergence of high-level vancomycin-resistant S. aureus (VRSA) strains from the United States since 2002 (CDC, 2002a,b, 2004; Tenover and McDonald, 2005). The third type of reduced susceptibility to vancomycin in S. aureus is heterogenous vancomycin-intermediate resistance (hVISA), which had been first reported by Hiramatsu et al. in 1997. These various types of reduced susceptibility to vancomycin could lead to clinical failures of vancomycin treatment. This review will summarize the current epidemiology of S. aureus with reduced susceptibility to vancomycin, especially in Asian countries, as well as the resistance mechanism, clinical implications, and infection control measures.

Keywords

Staphylococcus Aureus Clinical Microbiology Clinical Infectious Disease Vancomycin Resistance Skin Structure Infection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Ariza, J., Pujol, M., Cado, J., Pena, C., et al. (1999). Vancomycin in surgical infections due to methicillin-resistant Staphylococcus aureus with heterogeneous resistance to vancomycin. Lancet, 353, 1587–1588PubMedCrossRefGoogle Scholar
  2. Bert, F., Clarissou, J., Durand, F., et al. (2003). Prevalence, molecular epidemiology, and clinical significance of heterogeneous glycopeptide-intermediate Staphylococcus aureus in liver transplant recipients. Journal of Clinical Microbiology, 41, 5147–5152PubMedCrossRefGoogle Scholar
  3. Centers for Disease Control and Prevention. (1997). Interim guidelines for prevention and control of staphylococcal infections associated with reduced susceptibility to vancomycin. Morbidity and Mortality Weekly Report, 46, 626–628, 635Google Scholar
  4. Centers for Disease Control and Prevention. (2002a). Staphylococcus aureus resistant to vancomycin-United States, 2002. Morbidity and Mortality Weekly Report, 51, 565–567Google Scholar
  5. Centers for Disease Control and Prevention. (2002b). Vancomycin-resistant Staphylococcus aureus-Pennsylvania, 2002. Morbidity and Mortality Weekly Report, 51, 902Google Scholar
  6. Centers for Disease Control and Prevention. (2004). Vancomycin-resistant Staphylococcus aureus-New York, 2004. Morbidity and Mortality Weekly Report, 53, 322–323Google Scholar
  7. Chang, S., Sievert, D. M., Hageman, J. C., et al. (2003). Infection with vancomycin-resistant Staphylococcus aureus containing the vanA resistance gene. New England Journal of Medicine, 348, 1342–1347PubMedCrossRefGoogle Scholar
  8. Charles, P. G., Ward, P. G., Johnson, P. D., Howden, B. P., Grayson, M. L. (2004). Clinical features associated with bacteremia due to heterogeneous vancomycin-intermediate Staphylococcus aureus. Clinical Infectious Diseases, 8, 448–451CrossRefGoogle Scholar
  9. Clark, N. C., Weigel, L. M., Patel, J. B., Tenover, F. C. (2005). Comparison of Tn1546-like elements in vancomycin-resistant Staphylococcus aureus isolates from Michigan and Pennsylvania. Antimicrobial Agents and Chemotherapy, 49, 470–472PubMedCrossRefGoogle Scholar
  10. Clinical and Laboratory Standards Institute. (2006). Performance standards for antimicrobial susceptibility testing; fifteenth informational supplement. CLSI/NCCLS document M100–S16. CLSI, Wayne, PAGoogle Scholar
  11. Cosgrove, S. E., Carroll, K. C., Perl, T. M. (2004). Staphylococcus aureus with reduced susceptibility to vancomycin. Clinical Infectious Diseases, 39, 539–545PubMedCrossRefGoogle Scholar
  12. Cui, L., Ma, X., Sato, K., et al. (2003). Cell wall thickening is a common feature of vancomycin resistance in Staphylococcus aureus. Journal of Clinical Microbiology, 41, 5–14PubMedCrossRefGoogle Scholar
  13. Fridkin, S., Hagman, K. J., McDougal, L. K., Mohammed, J., Jarvis, W. R., Perl, T. M., Tenover, F. C.; and vancomycin-intermediate Staphylococcus aureus Epidemiology Study Group. (2003). Epidemiological and microbiological characterization of infections caused by Staphylococcus aureus with reduced susceptibility to vancomycin, United States, 1997–2001. Clinical Infectious Diseases, 36, 429–439PubMedCrossRefGoogle Scholar
  14. Goldstein, F. W., Kitzis, M. D. (2003). Vancomycin-resistant Staphylococcus aureus: no apocalypse now. Clinical Microbiology and Infection, 9, 761–765PubMedCrossRefGoogle Scholar
  15. Haraga, I., Nomura, S., Fukamachi, S., Ohjimi, H., Hanaki, H., Hiramatsu, K., Nagayama, A. (2002). Emergence of vancomycin resistance during therapy against methicillin-resistant Staphylococcus aureus in a burn patient – importance of low-level resistance to vancomycin. International Journal of Infectious Diseases, 6, 302–308PubMedCrossRefGoogle Scholar
  16. Hiramatsu, K., Aritaka, N., Hanaki, H., et al. (1997). Dissemination in Japanese hospitals of strains of Staphylococcus aureus heterogeneously resistant to vancomycin. Lancet, 350, 1670–1673PubMedCrossRefGoogle Scholar
  17. Hiramatsu, K. (1998). The emergence of Staphylococcus aureus with reduced susceptibility to vancomycin in Japan. American Journal of Medicine, 104, 7S–10SPubMedCrossRefGoogle Scholar
  18. Hiramatsu, K. (2001). Vancomycin-resistant Staphylococcus aureus: a new model of antibiotic resistance. Lancet Infectious Diseases, 1, 147–155PubMedCrossRefGoogle Scholar
  19. Hiramatsu, K., Hanaki, H., Ino, T., Yabuta, K., Oguri, T., Tenover, F. C. (1997). Methicilllin-reistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. Journal of Antimicrobial Chemotherapy, 40, 135–136PubMedCrossRefGoogle Scholar
  20. Hiramatsu, K., Kapi, M., Tajima, Y., Cui, L., Trakulsomboon, S., Ito, T. (2005). Advances in vancomycin resistance: research in Staphylococcus aureus. In White D. G., Alekshun M. N., Hawkins P.F. (Eds.), Frontiers in Antimicrobial Resistance: A Tribute to Stuart Levy, Washington DC, ASM Press, pp. 289–296Google Scholar
  21. Howe, R. A., Monk, A., Wootton, M., Walsh, T. R., Enright, M. C. (2004). Vancomycin susceptibility within methicillin-resistant Staphylococcus aureus lineages. Emerging Infectious Diseases, 10, 855–857PubMedGoogle Scholar
  22. Howe, R. A., Walsh, T. R. (2004). hGISA: seek and ye shall find. Lancet, 364, 500–501PubMedCrossRefGoogle Scholar
  23. Ike, Y., Arakawa, Y., Ma, X., Takewaki, K., Nagasawa, M., Tomita, H., Tanimoto, K., Fujimoto, S. (2001). Nationwide survey shows that methicillin-resistant Staphylococcus aureus strains heterogeneously and intermediately resistant to vancomycin are not disseminated throughout Japanese hospitals. Journal of Clinical Microbiology, 39, 4445–4451PubMedCrossRefGoogle Scholar
  24. Kim, H. B., Park, W. B., Lee, K. D., et al (2003). Nationwide surveillance of Staphylococcus aureus with reduced susceptibility to vancomycin in Korea. Journal of Clinical Microbiology, 41, 2279–2281PubMedCrossRefGoogle Scholar
  25. Kim, M.-N., Pai, C. H., Woo, J. H., Ryu, J. S., Hiramatsu, K. (2000). Vancomycin-intermediate Staphylococcus aureus in Korea. Journal of Clinical Microbiology, 38, 3879–3881PubMedGoogle Scholar
  26. Kim, M.-N., Hwang, S. H., Pyo, Y.-J., Mun, H.-N., Pai, C. H. (2002). Clonal spread of Staphylococcus aureus heterogeneously resistant to vancomycin in a university in Korea. Journal of Clinical Microbiology, 40, 1376–1380PubMedCrossRefGoogle Scholar
  27. Liñares, J. (2001). The VISA/GISA problem: therapeutic implications. Clinical Microbiology and Infection, 7 (Suppl 4), 8–15PubMedCrossRefGoogle Scholar
  28. Lu, J.-J., Lee, S.-Y., Hwa, S.-Y., Yang, A.-H. (2005). Septic arthritis caused by vancomycin-intermediate Staphylococcus aureus. Journal of Clinical Microbiology, 43, 4156–4158PubMedCrossRefGoogle Scholar
  29. Moore, M. R., Perdreau-Remington, F., Chambers, H. F. (2003). Vancomycin treatment failure associated with heterogeneous vancomycin-intermediate Staphylococcus aureus in a patient with endocarditis and in the rabbit model of endocarditis. Antimicrobial Agents and Chemotherapy, 47, 1262–1266PubMedCrossRefGoogle Scholar
  30. Noble, W. C., Virami, Z., Cree, R. G. (1992). Co-transfer of vancomycin and other resistance genes from Enterococcus faecalis NCTC 12201 to Staphylococcus aureus. FEMS Microbiology Letter, 72, 195–198CrossRefGoogle Scholar
  31. Song, J. H., Hiramatsu, K., Suh, J. Y., et al. (2004). Emergence in Asian countries of Staphylococcus aureus with reduced susceptibility to vancomycin. Antimicrobial Agents and Chemotherapy, 48, 4926–4928PubMedCrossRefGoogle Scholar
  32. Sng, L.-H., Koh, T. S., Hsu, L.-Y., Kapi, M. (2005). Heterogeneous vancomycin-resistant Staphylococcus aureus (hetero-VISA) in Singapore. International Journal of Antimicrobial Agents, 25, 177–184PubMedCrossRefGoogle Scholar
  33. Schwaber, M. J., Wright, S. B., Carmeli, Y., et al. (2003). Clinical implications of varying degrees of vancomycin suscepbility in methicillin-resistant Staphylococcus aureus bacteremia. Emerging Infectious Diseases, 9, 657–664PubMedGoogle Scholar
  34. Tenover, F. C., McDonald, L. C. (2005). Vancomycin-resistant staphylococci and enterococci: epidemiology and control. Current Opinion in Infectious Diseases, 18, 300–305PubMedCrossRefGoogle Scholar
  35. Tenover, F. C., Lancaster, M. V., Hill, B. C. (1998). Characterization of staphylococci with reduced susceptibilities to vancomycin and other glycopeptides. Journal of Clinical Microbiology, 36, 1020–1027PubMedGoogle Scholar
  36. Tenover, F. C., Biddle, J. W., Lancaster, M. V. (2001). Increasing resistance to vancomycin and other glycopeptides in Staphylococcus aureus. Emerging Infectious Diseases, 7, 327–332PubMedCrossRefGoogle Scholar
  37. Trakulsomboon, S., Danchaivijitr, S., Rongrungruang, Y., Dhiraputra, C., Susaemgrat, W., Ito, T., Hiramatsu, K. (2001). First report of methicillin-resistant Staphylococcus aureus with reduced susceptibility to vancomycin in Thailand. Journal of Clinical Microbiology, 39, 591–595PubMedCrossRefGoogle Scholar
  38. Walsh, T. R., Howe, R. A. (2002). The prevalence and mechanisms of vancomycin resistance in Staphylococcus aureus. Annual of Review of Microbiology, 56, 657–675CrossRefGoogle Scholar
  39. Wang, G., Hindler, J. F., Ward, K. W., Bruckner, D. A. (2006). Increased vancomycin MICs for Staphylococcus aureus clinical isolates from a university hospital during a 5-year period. Journal of Clinical Microbiology, 44, 3883–3886PubMedCrossRefGoogle Scholar
  40. Wang, J.-L., Tseng, S.-P., Hsueh, P.-R., Hiramatsu, K. (2004). Vancomycin heteroresistance in methicillin-resistant Staphylococcus aureus, Taiwan. Emerging Infectious Diseases, 10, 1702–1704PubMedGoogle Scholar
  41. Weigel, L. M., Clewell, D. B., Gill, S. R., et al. (2003). Genetic analysis of a high-level vancomycin-resistant isolate of Staphylococcus aureus. Science, 302, 1569–1571PubMedCrossRefGoogle Scholar
  42. Whitener, C. J., Park, S. Y., Browne, F. A., et al. (2004). Vancomycin-resistant Staphylococcus aureus in the absence of vancomycin exposure. Clinical Infectious Diseases, 38, 1049–1055PubMedCrossRefGoogle Scholar
  43. Wong, S. S. Y., Ho, P. L., Woo, P. C., Yuen, K. Y. (1999). Bacteremia caused by staphylococci with inducible vancomycin heteroresistance. Clinical Infectious Diseases, 29, 760–767PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Jae-Hoon Song
    • 1
  1. 1.Samsung Medical CenterSungkyunkwan University School of MedicineKorea

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