title: Relationship between vancomycin-resistant Staphylococcus aureus, vancomycin-intermediate S. aureus, high vancomycin MIC, and outcome in serious S. aureus infections.
abstract: Vancomycin has been used successfully for over 50 years for the treatment of Staphylococcus aureus infections, particularly those involving methicillin-resistant S. aureus. It has proven remarkably reliable, but its efficacy is now being questioned with the emergence of strains of S. aureus that display heteroresistance, intermediate resistance, and, occasionally, complete vancomycin resistance. More recently, an association has been established between poor outcome and infections with strains of S. aureus with an elevated vancomycin MIC within the susceptible range. This minireview summarizes the definitions, mechanisms, clinical impact, and laboratory identification of reduced vancomycin susceptibility in S. aureus and discusses practical issues for the diagnostic laboratory in testing and interpreting vancomycin susceptibility for S. aureus infections.
authors.affiliation: Austin Centre for Infection Research, Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, USA.
authors.forename: Natasha E
authors.initials: NE
authors.lastname: Holmes
authors.forename: Paul D R
authors.initials: PD
authors.lastname: Johnson
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Howden
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D006801:Humans; D008826:Microbial Sensitivity Tests; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects*; D016896:Treatment Outcome; D020713:Vancomycin Resistance
chemical_list: D000900:Anti-Bacterial Agents