Vancomycin-resistant Staphylococcus aureus: Difference between revisions

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'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
{{Vancomycin-resistant Staphylococcus aureus}}
{{Vancomycin-resistant Staphylococcus aureus}}
{{CMG}}
{{CMG}}
===== References =====
http://www.cdc.gov/ncidod/dhqp/ar_visavrsa.html
===== References =====
http://www.cdc.gov/ncidod/dhqp/ar_visavrsa_FAQ.html#3
===== References =====
http://www.cdc.gov/ncidod/dhqp/ar_visavrsa_FAQ.html#3
===== References =====
http://www.cdc.gov/ncidod/dhqp/ar_visavrsa_labFAQ.html
== Pathophysiology & Etiology==
VISA and VRSA are specific types of antimicrobial-resistant '''staph bacteria'''.
''What is Staphylococcus aureus?''
Staphylococcus aureus, often simply referred to simply as “staph”, are bacteria commonly found on the skin and in the noses of healthy people. Occasionally, staph can cause infection; staph bacteria are one of the most common causes of skin infections in the United States.
===== References =====
http://www.cdc.gov/ncidod/dhqp/ar_visavrsa_FAQ.html#3
http://www.cdc.gov/ncidod/dhqp/ar_visavrsa_FAQ.html#1


== Natural History ==
{{SK}} VRSA; VISA; vancomycin-intermediate Staphylococcus aureus


===== References =====
==[[Vancomycin-resistant Staphylococcus aureus overview|Overview]]==
http://en.wikidoc.org/index.php?title=VISA_/_VRSA:_Vancomycin-Intermediate/Resistant_Staphylococcus_aureus&action=edit


===== References =====
==[[Vancomycin-resistant Staphylococcus aureus historical perspective|Historical Perspective]]==


=== Laboratory Findings ===
==[[Vancomycin-resistant Staphylococcus aureus classification|Classification]]==
[[Image:VAalgoApril06v7 sml.gif|frame|left|Algorithm for Testing S. aureus with Vancomycin (VA)]]


All laboratories should develop a step-by-step problem-solving procedure or algorithm for detecting VISA/VRSA that is specific for their laboratory. A sample algorithm is available here and highlights the recommended testing methodologies for detecting VISA/VRSA and actions based on results.
==[[Vancomycin-resistant Staphylococcus aureus pathophysiology|Pathophysiology]]==


Not all susceptibility testing methods detect VISA and VRSA isolates. Three out of six confirmed VRSA isolates were not reliably detected by automated testing systems in a recent report. Subsequently, some manufacturers have optimized their systems for VRSA detection, so laboratories should check with manufacturers to determine if their system has FDA clearance for VRSA detection. VRSA are detected by reference broth microdilution, agar dilution, Etest®, MicroScan® overnight and Synergies plus™; BD Phoenix™ system, disk diffusion, and the vancomycin screen agar plate [brain heart infusion (BHI) agar containing 6 µg/ml of vancomycin].
==[[Vancomycin-resistant Staphylococcus aureus causes|Causes]]==


VISA isolates are not detected by disk diffusion. Methods that typically detect VISA are non-automated MIC methods including reference broth microdilution, agar dilution, and Etest® using a 0.5 McFarland standard to prepare inoculum. Automated methods and vancomycin screen agar plates usually detect VISA for which the vancomycin MICs are 8 µg/ml, but further studies are need to define the level of sensitivity of these methods for S. aureus for which the vancomycin MICs are 4 µg/ml.
==[[Vancomycin-resistant Staphylococcus aureus epidemiology and demographics|Epidemiology and Demographics]]==
<br clear="left"/>
==== Electrolyte and Biomarker Studies ====


=====References=====
==[[Vancomycin-resistant Staphylococcus aureus risk factors|Risk Factors]]==
http://www.cdc.gov/ncidod/dhqp/ar_visavrsa_algo.html
http://www.cdc.gov/ncidod/dhqp/ar_visavrsa_labFAQ.html


== Treatment ==
==[[Vancomycin-resistant Staphylococcus aureus screening|Screening]]==  
VISA and VRSA cannot be successfully treated with vancomycin because these organisms are no longer susceptibile to vancomycin. However, to date, all VISA and VRSA isolates have been susceptible to other Food and Drug Administration (FDA) approved drugs.


=== Pharmacotherapy ===
==[[Vancomycin-resistant Staphylococcus aureus natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


===== References =====
==Diagnosis==
http://www.cdc.gov/ncidod/dhqp/ar_visavrsa.html
[[Vancomycin-resistant Staphylococcus aureus history and symptoms|History and Symptoms]] | [[Vancomycin-resistant Staphylococcus aureus physical examination|Physical Examination]] | [[Vancomycin-resistant Staphylococcus aureus laboratory findings|Laboratory Findings]] | [[Vancomycin-resistant Staphylococcus aureus chest x ray|Chest X Ray]] | [[Vancomycin-resistant Staphylococcus aureus CT|CT]] | [[Vancomycin-resistant Staphylococcus aureus MRI|MRI]] | [[Vancomycin-resistant Staphylococcus aureus echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Vancomycin-resistant Staphylococcus aureus other imaging findings|Other Imaging Findings]] | [[Vancomycin-resistant Staphylococcus aureus other diagnostic studies|Other Diagnostic Studies]]


=== Primary Prevention ===
==Treatment==
Use of appropriate infection control practices (such as wearing gloves before and after contact with infectious body substances and adherence to hand hygiene) by healthcare personnel can reduce the spread of VISA and VRSA.
[[Vancomycin-resistant Staphylococcus aureus medical therapy|Medical Therapy]] | [[Vancomycin-resistant Staphylococcus aureus surgery|Surgery]] | [[Vancomycin-resistant Staphylococcus aureus primary prevention|Primary Prevention]] | [[Vancomycin-resistant Staphylococcus aureus secondary prevention|Secondary Prevention]] | [[Vancomycin-resistant Staphylococcus aureus cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Vancomycin-resistant Staphylococcus aureus future or investigational therapies|Future or Investigational Therapies]]


===== References =====
==Case Studies==
http://www.cdc.gov/ncidod/dhqp/ar_visavrsa_FAQ.html#3
[[Vancomycin-resistant Staphylococcus aureus case study one|Case #1]]
 
=== Secondary Prevention ===
Because VISA and VRSA are only part of the larger problem of antimicrobial resistance in healthcare settings, CDC has started a Campaign to Prevent Antimicrobial Resistance. The campaign centers around four strategies that clinicians can use to prevent antimicrobial resistance: prevent infections; diagnose and treat infections effectively; use antimicrobials wisely; and prevent transmission. A series of evidence-based steps are described that can reduce the development and spread of resistant organisms such as VISA and VRSA.
 
===== References =====
http://www.cdc.gov/ncidod/dhqp/ar_visavrsa_FAQ.html#3
 
 
==Additional Resources==
* {{note|1}} Chang S, Sievert DM, Hageman JC, Boulton ML, Tenover FC, Downes FP, Shah S, Rudrik JT, Pupp GR, Brown WJ, Cardo D, Fridkin SK. ''Infection with vancomycin-resistant Staphylococcus aureus containing the vanA resistance gene.'' N Engl J Med 2003;348:1342-7. PMID 12672861.


==Related Chapters==
==Related Chapters==
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* [[Drug resistance]]
* [[Drug resistance]]
* [[MRSA]]
* [[MRSA]]
==External Links==
http://www.cdc.gov/ncidod/dhqp/ar_visavrsa.html


[[fr:Staphylococcus aureus résistant à la vancomycine]]
[[fr:Staphylococcus aureus résistant à la vancomycine]]
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[[Category:Staphylococcaceae]]
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Latest revision as of 19:06, 18 September 2017

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Synonyms and keywords: VRSA; VISA; vancomycin-intermediate Staphylococcus aureus

Overview

Historical Perspective

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Pathophysiology

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Epidemiology and Demographics

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