title: [Cloxacillin-susceptible Staphylococcus aureus with high MIC to glycopeptides. Ever we use cloxacillin?].
abstract: Staphylococcus aureus infections are yet an important cause of morbidity and mortality despite of numerous effective anti-staphylococcal antibiotics available. There has been an increasing incidence of methicillin-resistant strains which might have led to a wider use of vancomycin. This seems to ride alongside a covert progressive increase of S. aureus vancomycin minimum inhibitory concentration. In this way, the emergence of vancomycin-intermediate S. aureus (VISA) strains and heteroresistant-VISA has raised concern for the scarcity of alternative treatment options. Equally alarming, though fortunately less frequent, is the emergence of vancomycin-resistant S. aureus. Ultimately, various debate issues have arisen regarding the emergence of S. aureus strains with decreased vancomycin susceptibility, within the range still considered sensitive. These strains have shown a different clinical behaviour regardless of vancomycin use, both in methicillin resistant and sensitive S. aureus. The emergence of increasing vancomycin-resistance in S. aureus isolates, has stirred up the basis of therapeutic approach in staphylococcal infections. There is yet much to explore to better define the impact of higher vancomycin minimum inhibitory concentration in staphylococcal infections.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Morales-Cartagena
authors.forename: Antonio
authors.initials: A
authors.lastname: Lalueza
authors.forename: Rafael
authors.initials: R
authors.lastname: San Juan
authors.affiliation: José María Aguado, Unidad de Enfermedades Infecciosas. Hospital Universitario 12 de Octubre, Madrid, Spain. jaguadog1@gmail.com.
authors.forename: José María
authors.initials: JM
authors.lastname: Aguado
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D003023:Cloxacillin / Q000494:pharmacology* / Q000627:therapeutic use*; D006020:Glycopeptides / Q000494:pharmacology* / Q000627:therapeutic use*; D006801:Humans; D008826:Microbial Sensitivity Tests; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013210:Staphylococcus / Q000187:drug effects; D014640:Vancomycin / Q000494:pharmacology / Q000627:therapeutic use; D020713:Vancomycin Resistance
chemical_list: D000900:Anti-Bacterial Agents; D006020:Glycopeptides; D014640:Vancomycin; D003023:Cloxacillin