Vancomycin is a glycopeptide antibiotic used for the treatment of Gram-positive bacterial infections. Traditionally, it has been used as a drug of last resort; however, clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) strains with decreased susceptibility to vancomycin (vancomycin intermediate-resistant S. aureus [VISA]) and more recently with high-level vancomycin resist...

Multidrug resistant Staphylococcus aureus (MDRS) is a serious threat to hospitalized patients globally and now represents a challenge for public health, as community-acquired infections appear to be on the increase in both adults and children. S. aureus colonization has been shown to be a risk factor for community-acquired and nosocomial infections. A total of 130 subjects from the community an...

Vancomycin has been the most reliable therapeutic agent against infections caused by meticillin-resistant Staphylococcus aureus (MRSA). However, in 1996 the first MRSA to acquire resistance to vancomycin, was isolated from a Japanese patient. The patient had contracted a post-operative wound infection that was refractory to long-term vancomycin therapy. Subsequent isolation of several vancomyci...

In 2002, the first two clinical isolates of vancomycin-resistant Staphylococcus aureus (VRSA) containing vanA were recovered in Michigan and Pennsylvania. Tn1546, a mobile genetic element that encodes high-level vancomycin resistance in enterococci, was present in both isolates. With PCR and DNA sequence analysis, we compared the Tn1546 elements from each isolate to the prototype Tn1546 element...

The first S. aureus strain with a vancomycin MIC 8 mg/L was isolated in 1996 from a Japanese patient to whom vancomycin therapy was ineffective [1]. Subsequently, dozens of VRSA strains were isolated from USA, France, Korea, South Africa, Scotland and Brazil [2], indicating that the issue is a global one [3]. However, the real essence of the issue lies in the latent dissemination of «hetero-VRS...

Vancomycin resistance of Staphylococcus aureus NY-VRSA and VRSA-5 is due to acquisition of a vanA operon located in a Tn1546-like element. The vanA gene cluster of NY-VRSA contained one copy of insertion sequences IS1251 and IS1216V relative to that of VRSA-5. As evidenced by the nature of the late peptidoglycan precursors and by quantification of d,d-peptidase activities, the vancomycin resist...

For 3 decades, vancomycin has been a favored therapy for serious penicillinand cephalosporin-resistant Gram-positive bacterial infections. Development of vancomycin resistance may have been restrained by the requirement for intravenous administration, which limited its use and lessened exposure to the gastrointestinal flora. Nevertheless, physicians are increasingly encountering children and ad...

We report findings from our investigation of the world's second clinical isolate of vancomycin-resistant Staphylococcus aureus (VRSA). An elderly man was hospitalized with an infected chronic heel ulcer and osteomyelitis. Before hospital admission, he received multiple courses of antibiotic therapy but, notably, no vancomycin. Numerous cultures of ulcer specimens (performed on an outpatient bas...

There have been conflicting data about the interactions between vancomycin and beta-lactam agents against Staphylococcus aureus strains with heterogeneous resistance to vancomycin. We evaluated the efficacy of these combinations against Mu 3 and heterogeneously vancomycin-resistant S. aureus (hetero-VRSA) strains which were isolated from Korean patients using a population analysis method. Antag...