204:
2512:
628:
2542:
2552:
36:
1713:
2532:
1429:
2522:
77:
124:
414:
288:. Bacteria can acquire resistant genes either by random mutation or through the transfer of DNA from one bacterium to another. Resistance genes interfere with the normal antibiotic function and allow bacteria to grow in the presence of the antibiotic. Resistance in VRSA is conferred by the plasmid-mediated
624:), indicating resistance to all glycopeptide antibiotics. These bacterial strains present a thickening of the cell wall, which is believed to reduce the ability of vancomycin to diffuse into the division septum of the cell required for effective vancomycin treatment.
292:
gene and operon. Although VRSA infections are uncommon, VRSA is often resistant to other types of antibiotics and a potential threat to public health because treatment options are limited. VRSA is resistant to many of the standard drugs used to treat
1679:
1186:"Reduced Vancomycin Susceptibility in Staphylococcus aureus, Including Vancomycin-Intermediate and Heterogeneous Vancomycin-Intermediate Strains: Resistance Mechanisms, Laboratory Detection, and Clinical Implications"
49:
402:
1456:
1603:
Chang, Soju; Sievert, Dawn M.; Hageman, Jeffrey C.; Boulton, Matthew L.; Tenover, Fred C.; Downes, Frances Pouch; Shah, Sandip; Rudrik, James T.; Pupp, Guy R. (April 3, 2003).
908:"Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus Aureus Infections in Adults and Children"
1135:
Chang, Soju; Sievert, Dawn M.; Hageman, Jeffrey C.; Boulton, Matthew L.; Tenover, Fred C.; Downes, Frances Pouch; Shah, Sandip; Rudrik, James T.; Pupp, Guy R. (2003-04-03).
812:
The definition of hVISA according to
Hiramatsu et al. is a strain of Staphylococcus aureus that gives resistance to vancomycin at a frequency of 10 colonies or even higher.
142:
1241:
CLSI (2023). M100 Performance
Standards for Antimicrobial Susceptibility Standards (Report) (33 ed.). Wayne PA: Clinical and Laboratory Standards Institute. p. 8.
55:
398:
343:(VISA), which appear to develop elevated MICs to vancomycin through sequential mutations resulting in a thicker cell wall and the synthesis of excess amounts of
1573:
1346:, including vancomycin-intermediate and heterogeneous vancomycin-intermediate strains: resistance mechanisms, laboratory detection, and clinical implications"
749:
463:
394:
2041:
2382:
98:
85:
1981:
2586:
436:, alternative antibiotics should be used. The approach is to treat with at least one agent to which the bacteria known to be susceptible by
2281:
2417:
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1439:
775:
318:
178:
160:
63:
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753:
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309:
was first reported in the United States in 2002. To date, documented cases of VRSA have acquired resistance through uptake of a
2407:
1841:
383:
490:
2387:
389:
Resistant or "R" designations are assigned based on agreed upon values called breakpoints. Breakpoints are published by
211:
2031:
17:
2581:
804:
As of 2019, 52 VRSA strains have been identified in the United States, India, Iran, Pakistan, Brazil, and
Portugal.
2576:
2011:
1184:
Howden, Benjamin P.; Davies, John K.; Johnson, Paul D. R.; Stinear, Timothy P.; Grayson, M. Lindsay (2010-01-01).
90:
2440:
767:
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344:
282:
1804:
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390:
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2341:
2314:
2287:
2239:
2193:
1888:
1525:"Vancomycin resistant Staphylococcus aureus infections: A review of case updating and clinical features"
1080:"Vancomycin resistant Staphylococcus aureus infections: A review of case updating and clinical features"
669:
632:
277:
220:
2475:
2435:
2302:
2116:
2111:
2091:
2026:
1878:
473:
in the setting of vancomycin failure the
Infectious Diseases Society of America recommends high-dose
386:. Once the MIC is known, resistance is determined by comparing the MIC with established breakpoints
1293:"Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility"
2555:
2497:
2480:
2139:
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1683:
455:
375:
2541:
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2181:
2134:
2101:
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1824:
605:
1137:"Infection with Vancomycin-Resistant Staphylococcus aureus Containing the vanA Resistance Gene"
2515:
2397:
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2292:
2207:
2171:
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2056:
1976:
1920:
1883:
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1910:
1620:
1544:
1536:
1495:
1402:
1365:
1357:
1304:
1265:
1252:
Appelbaum PC (November 2007). "Reduced glycopeptide susceptibility in methicillin-resistant
1213:
1197:
1148:
1107:
1091:
1050:
1002:
984:
919:
875:
857:
718:
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570:
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215:
203:
973:"Editorial: Genetics of Acquired Antimicrobial Resistance in Animal and Zoonotic Pathogens"
2545:
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2319:
2259:
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1819:
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821:
1718:
1291:
Hiramatsu, K.; Hanaki, H.; Ino, T.; Yabuta, K.; Oguri, T.; Tenover, F. C. (1997-07-01).
2377:
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1341:
1218:
1185:
1112:
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1038:
1007:
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297:
infections. Furthermore, resistance can be transferred from one bacterium to another.
1406:
1269:
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2001:
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2021:
1996:
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experiments reported in 1992 demonstrated that vancomycin resistance genes from
494:
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1986:
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310:
285:
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1103:
998:
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370:
isolate to vancomycin. This is accomplished by first assessing the isolate's
2485:
2227:
2222:
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2064:
1939:
1903:
862:
486:
447:
413:
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1309:
1292:
1277:
1227:
1170:
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1064:
1016:
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76:
1326:
477:, if the isolate is susceptible, in combination with another agent (e.g.,
1991:
1768:
1625:
1604:
1361:
1201:
1153:
1136:
924:
907:
846:"Methicillin and Vancomycin Resistant S. aureus in Hospitalized Patients"
657:
438:
1671:
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1930:
1898:
1791:
1656:
1431:
Bacterial Toxins: Genetics, Cellular
Biology and Practical Applications
790:
663:
1340:
Howden BP, Davies JK, Johnson PD, Stinear TP, Grayson ML (Jan 2010).
1037:
McGuinness, Will A.; Malachowa, Natalia; DeLeo, Frank (23 Jun 2017).
744:) was isolated from a patient in Michigan. The isolate contained the
617:
609:
366:(VRSA) is performed by performing susceptibility testing on a single
971:
Cloeckaert, Axel; Zygmunt, Michel S.; Doublet, Benoît (2017-12-05).
1500:
1483:
1393:
Gould IM (December 2010). "VRSA-doomsday superbug or damp squib?".
844:
Loomba, Poonam Sood; Taneja, Juhi; Mishra, Bibhabati (2010-01-01).
626:
597:
379:
337:
225:
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of the VRSA isolate were consistent with the VanA phenotype of
685:. Until 2002 such a genetic transfer was not reported for wild
724:
576:
553:
117:
70:
29:
727:
701:
1737:
736:
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600:
in 1996 and has since been found in hospitals elsewhere in
588:
582:
579:
559:
1078:
Cong, Yanguang; Yang, Sijin; Rao, Xiancai (January 2020).
403:
European
Committee on Antimicrobial Susceptibility Testing
808:
Heterogeneous vancomycin-intermediate S. aureus (hVISA)
138:
18:
384:
automated antimicrobial susceptibility testing systems
1572:
Lu, Yichen; Essex, Max; Roberts, Bryan (2008-04-11).
733:
704:
585:
556:
1661:
721:
698:
620:. It is also termed GISA (glycopeptide-intermediate
573:
550:
2428:
2366:
2127:
2055:
2010:
1919:
1790:
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1665:
695:
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255:
245:
235:
196:
133:
may be too technical for most readers to understand
1523:Cong, Yanguang; Yang, Sijin; Rao, Xiancai (2020).
681:, conferring high-level vancomycin resistance to
1039:"Vancomycin Resistance in Staphylococcus aureus"
948:"CDC - VISA / VRSA in Healthcare Settings - HAI"
793:carried by the VRSA isolate. This transposon, Tn
1484:"Vancomycin resistance in gram-positive cocci"
517:(VISA), heterogeneous vancomycin-intermediate
399:British Society for Antimicrobial Chemotherapy
1753:
521:(hVISA), and high-level vancomycin-resistant
374:using standard laboratory methods, including
8:
801:-type vancomycin resistance in enterococci.
785:gene was later found to be encoded within a
395:Clinical and Laboratory Standards Institute
321:). The acquired mechanism is typically the
64:Learn how and when to remove these messages
2042:Reproductive endocrinology and infertility
1787:
1760:
1746:
1738:
1729:Vancomycin-resistant Staphylococcus aureus
1662:
781:recovered from the same catheter tip. The
442:testing. The agents that are used include
202:
197:Vancomycin-resistant Staphylococcus aureus
193:
2383:Bachelor of Medicine, Bachelor of Surgery
1624:
1578:. Springer Science & Business Media.
1548:
1499:
1369:
1308:
1217:
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1111:
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988:
923:
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861:
179:Learn how and when to remove this message
161:Learn how and when to remove this message
145:, without removing the technical details.
412:
101:of all important aspects of the article.
833:
509:have emerged that differ in vancomycin
336:This mechanism differs from strains of
259:Beta-lactam antibiotic (in combination)
1342:"Reduced vancomycin susceptibility in
901:
899:
505:Three classes of vancomycin-resistant
372:minimum inhibitory concentration (MIC)
362:The diagnosis of vancomycin-resistant
97:Please consider expanding the lead to
1605:"Infection with Vancomycin-Resistant
1297:Journal of Antimicrobial Chemotherapy
850:Journal of Global Infectious Diseases
839:
837:
281:that have acquired resistance to the
143:make it understandable to non-experts
7:
2521:
2282:Physical medicine and rehabilitation
1609:Containing the vanA Resistance Gene"
1458:Antimicrobial Resistance in Bacteria
1032:
1030:
1028:
1026:
906:Liu, Catherine; et al. (2011).
651:High-level vancomycin resistance in
2531:
391:standards development organizations
2418:Medical Scientist Training Program
1455:Amábile-Cuevas, Carlos F. (2007).
325:gene and operon from a plasmid in
25:
1270:10.1016/j.ijantimicag.2007.07.011
762:species, and the presence of the
689:strains. In 2002, a VRSA strain (
45:This article has multiple issues.
2550:
2540:
2530:
2520:
2511:
2510:
1711:
774:gene was identical to that of a
717:
691:
569:
543:
430:minimum inhibitory concentration
301:Mechanism of acquired resistance
122:
75:
34:
2551:
1613:New England Journal of Medicine
1141:New England Journal of Medicine
776:vancomycin-resistant strain of
770:. The DNA sequence of the VRSA
89:may be too short to adequately
53:or discuss these issues on the
2408:Doctor of Osteopathic Medicine
1842:Oral and maxillofacial surgery
99:provide an accessible overview
27:Antibiotica resistant bacteria
1:
2587:Antibiotic-resistant bacteria
1407:10.1016/S1473-3099(10)70259-0
1190:Clinical Microbiology Reviews
491:trimethoprim/sulfamethoxazole
313:resistance gene cluster from
2388:Bachelor of Medical Sciences
2155:Neurosurgical anesthesiology
1482:Courvalin P (January 2006).
1461:. Horizon Scientific Press.
1434:. Horizon Scientific Press.
1084:Journal of Advanced Research
912:Clinical Infectious Diseases
212:Scanning electron micrograph
1575:Emerging Infections in Asia
2608:
1541:10.1016/j.jare.2019.10.005
1258:Int. J. Antimicrob. Agents
1096:10.1016/j.jare.2019.10.005
655:has been rarely reported.
596:) was first identified in
513:: vancomycin-intermediate
2506:
977:Frontiers in Microbiology
768:polymerase chain reaction
460:quinupristin–dalfopristin
210:
201:
2342:Transplantation medicine
2233:Clinical neurophysiology
2150:Obstetric anesthesiology
2070:Interventional radiology
1830:Digestive system surgery
990:10.3389/fmicb.2017.02428
673:could be transferred by
537:Vancomycin-intermediate
529:Vancomycin-intermediate
380:gradient strip diffusion
338:vancomycin-intermediate
226:vancomycin-intermediate
2213:Intensive care medicine
2187:Mass gathering medicine
2032:Maternal–fetal medicine
863:10.4103/0974-777X.68535
283:glycopeptide antibiotic
1805:Cardiothoracic surgery
1428:Proft, Thomas (2013).
766:gene was confirmed by
750:methicillin resistance
639:
464:methicillin-resistant
425:
409:Treatment of infection
224:bacteria taken from a
2456:Personalized medicine
2315:Reproductive medicine
2240:Occupational medicine
2194:Evolutionary medicine
1607:Staphylococcus aureus
1344:Staphylococcus aureus
1254:Staphylococcus aureus
778:Enterococcus faecalis
670:Enterococcus faecalis
643:Vancomycin-resistant
630:
622:Staphylococcus aureus
466:Staphylococcus aureus
416:
364:Staphylococcus aureus
340:Staphylococcus aureus
331:Enterococcus faecalis
307:Staphylococcus aureus
305:Vancomycin-resistant
278:Staphylococcus aureus
268:Staphylococcus aureus
266:Vancomycin-resistant
228:Staphylococcus aureus
221:Staphylococcus aureus
2476:Traditional medicine
2436:Alternative medicine
2303:Addiction psychiatry
2117:Transfusion medicine
2112:Medical microbiology
2027:Gynecologic oncology
1879:Reproductive surgery
1626:10.1056/NEJMoa025025
1362:10.1128/CMR.00042-09
1350:Clin. Microbiol. Rev
1310:10.1093/jac/40.1.135
1202:10.1128/CMR.00042-09
1154:10.1056/NEJMoa025025
327:Enterococcus faecium
2498:History of medicine
2481:Veterinary medicine
2288:Preventive medicine
2140:Adolescent medicine
1982:Infectious diseases
1494:(Suppl 1): S25–34.
2582:Bacterial diseases
2446:Molecular oncology
2403:Doctor of Medicine
2393:Master of Medicine
2310:Radiation oncology
2182:Emergency medicine
2135:Addiction medicine
2102:Clinical chemistry
2097:Clinical pathology
1889:Transplant surgery
1847:Orthopedic surgery
1825:Colorectal surgery
925:10.1093/cid/ciq146
640:
606:the United Kingdom
462:. For people with
426:
2577:Staphylococcaceae
2564:
2563:
2398:Master of Surgery
2362:
2361:
2347:Tropical medicine
2293:Prison healthcare
2208:Hospital medicine
2172:Disaster medicine
2162:Aviation medicine
1977:Hospital medicine
1884:Surgical oncology
1869:Pediatric surgery
1863:
1810:Endocrine surgery
1706:
1705:
1619:(14): 1342–1347.
1488:Clin. Infect. Dis
1395:Lancet Infect Dis
1147:(14): 1342–1347.
432:of vancomycin is
393:such as the U.S.
351:
347:
275:) are strains of
263:
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247:Diagnostic method
191:Medical condition
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16:(Redirected from
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2524:
2523:
2514:
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2218:Medical genetics
2203:General practice
2080:Nuclear medicine
1955:Gastroenterology
1911:Vascular surgery
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604:, as well as in
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511:susceptibilities
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2491:Chief physician
2424:
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2352:Travel medicine
2337:Sports medicine
2320:Sexual medicine
2260:Palliative care
2255:Pain management
2199:Family medicine
2177:Diving medicine
2123:
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2013:
2006:
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1874:Plastic surgery
1820:General surgery
1800:Cardiac surgery
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1597:Further reading
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1043:Yale J Biol Med
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822:Drug resistance
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231:(VISA) culture.
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139:help improve it
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84:This article's
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2429:Related topics
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2145:Anesthesiology
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2075:Neuroradiology
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2018:
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2012:Obstetrics and
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1894:Trauma surgery
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1857:Otolaryngology
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1783:subspecialties
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1666:Classification
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2002:Rheumatology
1933: /
1852:Hand surgery
1837:Neurosurgery
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2536:Wikiproject
2325:Venereology
2270:Neonatology
2167:Dermatology
2022:Gynaecology
2014:gynaecology
1997:Pulmonology
1815:Eye surgery
1777:Specialties
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1090:: 169–176.
952:www.cdc.gov
495:beta-lactam
456:ceftaroline
2571:Categories
2298:Psychiatry
2284:(PM&R)
2277:Phlebology
2265:Pediatrics
2092:Anatomical
2057:Diagnostic
2037:Obstetrics
1987:Nephrology
1972:Hematology
1967:Geriatrics
1960:Hepatology
1945:Cardiology
1935:Immunology
1697:D000083123
957:2015-06-11
828:References
797:, confers
787:transposon
637:blood agar
479:gentamicin
475:daptomycin
471:bacteremia
452:telavancin
444:daptomycin
418:Rifampicin
354:residues.
311:vancomycin
286:vancomycin
50:improve it
2486:Physician
2370:education
2228:Neurology
2223:Narcology
2087:Pathology
2065:Radiology
1940:Angiology
1904:Andrology
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1210:0893-8512
1163:0028-4793
1104:2090-1232
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872:0974-777X
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679:S. aureus
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645:S. aureus
633:S. aureus
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523:S. aureus
519:S. aureus
515:S. aureus
507:S. aureus
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448:linezolid
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358:Diagnosis
295:S. aureus
256:Treatment
237:Specialty
91:summarize
56:talk page
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