title: Staphylococcus aureus with reduced susceptibility to vancomycin in healthcare settings.
abstract: Glycopeptide resistance in Staphylococcus aureus is a source of great concern because, especially in hospitals, this class of antibiotics, particularly vancomycin, is one of the main resources for combating infections caused by methicillin-resistant Staphylococcus aureus strains (MRSA). Reduced susceptibility to vancomycin (VISA) was first described in 1996 in Japan; since then, a phenotype with heterogeneous resistance to vancomycin (h-VISA) has emerged. H-VISA isolates are characterised by the presence of a resistant subpopulation, typically at a rate of 1 in 10(5) organisms, which constitutes the intermediate stage betweenfully vancomycin-susceptible S. aureus (VSSA) and VISA isolates. As VISA phenotypes are almost uniformly cross-resistant to teicoplanin, they are also called Glycopeptides-intermediate Staphylococcus aureus strains (GISA) and, in the case of heterogeneous resistance to glycopeptides, h-GISA. The overall prevalence of h-VISA is low, accounting for approximately 1.3% of all MRSA isolates tested. Mortality due to h-GISA infections is very high (about 70%), especially among patients hospitalised in high-risk departments, such as intensive care units (ICU). Given the great clinical relevance of strains that are heteroresistant to glycopeptides and the possible negative impact on treatment choices, it is important to draw up and implement infection control practices, including surveillance, the appropriate use of isolation precautions, staff training, hand hygiene, environmental cleansing and good antibiotic stewardship.
authors.forename: A M
authors.initials: AM
authors.lastname: Spagnolo
authors.forename: P
authors.initials: P
authors.lastname: Orlando
authors.forename: D
authors.initials: D
authors.lastname: Panatto
authors.forename: D
authors.initials: D
authors.lastname: Amicizia
authors.forename: F
authors.initials: F
authors.lastname: Perdelli
authors.forename: M L
authors.initials: ML
authors.lastname: Cristina
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D017576:Daptomycin; D063373:Hand Hygiene; D006801:Humans; D017053:Infection Control; D055624:Methicillin-Resistant Staphylococcus aureus / Q000502:physiology*; D015995:Prevalence; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000502:physiology; D014640:Vancomycin / Q000627:therapeutic use; D020713:Vancomycin Resistance / Q000502:physiology*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D017576:Daptomycin