| 词条 | Vancomycin-resistant Staphylococcus aureus |
| 释义 |
| name = Vancomycin-resistant Staphylococcus aureus | synonyms = | image = File:Staphylococcus aureus VISA.jpg | alt = | caption = Scanning electron micrograph (SEM) shows a strain of Staphylococcus aureus bacteria taken from a vancomycin intermediate resistant culture (VRSA). | pronounce = | field = Microbiology | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = Disk diffusion[1] | differential = | prevention = | treatment = Beta-lactam antibiotic (in combination)[2] | medication = | prognosis = | frequency = | deaths = }}Vancomycin-resistant Staphylococcus aureus are strains of Staphylococcus aureus that have become resistant to the glycopeptide antibiotic vancomycin.[1] Mechanism of acquired resistanceStrains of hVISA and VISA do not have resistant genes found in Enterococcus and the proposed mechanisms of resistance include the sequential mutations resulting in a thicker cell wall and the synthesis of excess amounts of D-ala-D-ala residues.[2] VRSA strain acquired the vancomycin resistance gene cluster vanA from VRE.[3] DiagnosisThe diagnosis of vancomycin-resistant Staphylococcus aureus can be done with disk diffusion(and VA screen plate)[4] Treatment of infectionFor isolates with a Vancomycin MIC {{nowrap|> 2 µg/mL}}, an alternative to Vancomycin should be used. The approach is to treat with at least one agent to which VISA/VRSA is known to be susceptible by in vitro testing. The agents that are used include daptomycin, linezolid, telavancin, ceftaroline, quinupristin–dalfopristin. For people with MRSA bacteremia in the setting of vancomycin failure the IDSA recommends high-dose daptomycin, if the isolate is susceptible, in combination with another agent (e.g. gentamicin, rifampin, linezolid, TMP-SMX, or a beta-lactam antibiotic).[5] HistoryThree classes of vancomycin-resistant S. aureus have emerged that differ in vancomycin susceptibilities: vancomycin-intermediate S. aureus (VISA), heterogeneous vancomycin-intermediate S. aureus (hVISA), and high-level vancomycin-resistant S. aureus (VRSA).[6] Vancomycin-intermediate S. aureus (VISA)VISA ({{IPAc-en|ˈ|v|iː|s|ə}} or {{IPAc-en|v|iː|aɪ|ɛ|s|eɪ}}) was first identified in Japan in 1996[7] and has since been found in hospitals elsewhere in Asia, as well as in the United Kingdom, France, the U.S., and Brazil. It is also termed GISA (glycopeptide-intermediate Staphylococcus aureus), indicating resistance to all glycopeptide antibiotics. These bacterial strains present a thickening of the cell wall, which is believed to reduce the ability of vancomycin to diffuse into the division septum of the cell required for effective vancomycin treatment.[8] Vancomycin-resistant S. aureus (VRSA)High-level vancomycin resistance in S. aureus has been rarely reported.[9] In vitro and in vivo experiments reported in 1992 demonstrated that vancomycin resistance genes from Enterococcus faecalis could be transferred by gene transfer to S. aureus, conferring high-level vancomycin resistance to S. aureus.[10] Until 2002 such a genetic transfer was not reported for wild S. aureus strains. In 2002, a VRSA strain ({{IPAc-en|ˈ|v|ɜr|s|ə}} or {{IPAc-en|v|iː|ɑr|ɛ|s|eɪ}}) was isolated from a patient in Michigan.[11] The isolate contained the mecA gene for methicillin resistance. Vancomycin MICs of the VRSA isolate were consistent with the VanA phenotype of Enterococcus species, and the presence of the vanA gene was confirmed by polymerase chain reaction. The DNA sequence of the VRSA vanA gene was identical to that of a vancomycin-resistant strain of Enterococcus faecalis recovered from the same catheter tip. The vanA gene was later found to be encoded within a transposon located on a plasmid carried by the VRSA isolate. This transposon, Tn1546, confers vanA-type vancomycin resistance in enterococci.[12] Heterogeneous vancomycin-intermediate S. aureus (hVISA)The definition of hVISA according to Hiramatsu et al. is a strain of Staphylococcus aureus that gives resistance to vancomycin at a frequency of 10−6 colonies or even higher.[13] See also
References1. ^{{Cite web|title = CDC - VISA / VRSA in Healthcare Settings - HAI|url = https://www.cdc.gov/HAI/organisms/visa_vrsa/visa_vrsa.html|website = www.cdc.gov|accessdate = 2015-06-11}} 2. ^{{Cite journal|last=Howden|first=Benjamin P.|last2=Davies|first2=John K.|last3=Johnson|first3=Paul D. R.|last4=Stinear|first4=Timothy P.|last5=Grayson|first5=M. Lindsay|date=2010-01-01|title=Reduced Vancomycin Susceptibility in Staphylococcus aureus, Including Vancomycin-Intermediate and Heterogeneous Vancomycin-Intermediate Strains: Resistance Mechanisms, Laboratory Detection, and Clinical Implications|journal=Clinical Microbiology Reviews|volume=23|issue=1|pages=99–139|doi=10.1128/CMR.00042-09|issn=0893-8512|pmc=2806658|pmid=20065327}} 3. ^{{Cite journal|last=Chang|first=Soju|last2=Sievert|first2=Dawn M.|last3=Hageman|first3=Jeffrey C.|last4=Boulton|first4=Matthew L.|last5=Tenover|first5=Fred C.|last6=Downes|first6=Frances Pouch|last7=Shah|first7=Sandip|last8=Rudrik|first8=James T.|last9=Pupp|first9=Guy R.|date=2003-04-03|title=Infection with Vancomycin-Resistant Staphylococcus aureus Containing the vanA Resistance Gene|journal=New England Journal of Medicine|volume=348|issue=14|pages=1342–1347|doi=10.1056/NEJMoa025025|issn=0028-4793|pmid=12672861}} 4. ^1 {{Cite journal|last=Loomba|first=Poonam Sood|last2=Taneja|first2=Juhi|last3=Mishra|first3=Bibhabati|date=2010-01-01|title=Methicillin and Vancomycin Resistant S. aureus in Hospitalized Patients|journal=Journal of Global Infectious Diseases|volume=2|issue=3|pages=275–283|doi=10.4103/0974-777X.68535|issn=0974-777X|pmid=20927290|pmc=2946685}} 5. ^1 {{Cite journal|url=http://cid.oxfordjournals.org/content/early/2011/01/04/cid.ciq146.full|title=Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus Aureus Infections in Adults and Children|last= Liu|first=Catherine|year=2011|volume=52|issue=3|pages=e18–e55|doi=10.1093/cid/ciq146|journal=Clinical Infectious Diseases|display-authors=etal|pmid=21208910}} 6. ^{{cite journal |author=Appelbaum PC |title=Reduced glycopeptide susceptibility in methicillin-resistant Staphylococcus aureus (MRSA) |journal=Int. J. Antimicrob. Agents |volume=30 |issue=5 |pages=398–408 |date=November 2007 |pmid=17888634 |doi=10.1016/j.ijantimicag.2007.07.011 |url=}} 7. ^{{Cite journal|last=Hiramatsu|first=K.|last2=Hanaki|first2=H.|last3=Ino|first3=T.|last4=Yabuta|first4=K.|last5=Oguri|first5=T.|last6=Tenover|first6=F. C.|date=1997-07-01|title=Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility.|url=http://jac.oxfordjournals.org/content/40/1/135|journal=Journal of Antimicrobial Chemotherapy|language=en|volume=40|issue=1|pages=135–136|doi=10.1093/jac/40.1.135|issn=0305-7453|pmid=9249217}} 8. ^{{cite journal |vauthors=Howden BP, Davies JK, Johnson PD, Stinear TP, Grayson ML | title=Reduced vancomycin susceptibility in Staphylococcus aureus, including vancomycin-intermediate and heterogeneous vancomycin-intermediate strains: resistance mechanisms, laboratory detection, and clinical implications | journal=Clin. Microbiol. Rev. |date=Jan 2010 | volume=23 | issue=1 | pages=99–139 | doi=10.1128/CMR.00042-09 | pmid=20065327 | pmc=2806658 | url=http://cmr.asm.org/cgi/content/full/23/1/99}} 9. ^{{cite journal |author=Gould IM |title=VRSA-doomsday superbug or damp squib? |journal=Lancet Infect Dis |volume=10 |issue=12 |pages=816–8 |date=December 2010 |pmid=21109164 |doi=10.1016/S1473-3099(10)70259-0 |url=}} 10. ^{{Cite book|title = Bacterial Toxins: Genetics, Cellular Biology and Practical Applications|url = https://books.google.com/?id=FdAAAgAAQBAJ&pg=PA119&dq=vancomycin+resistance+genes+from+Enterococcus+faecalis+could+be+transferred+by+horizontal+gene+transfer+to+S.+aureus,+conferring+high-level+vancomycin+resistance+to+S.+aureus#v=onepage&q=vancomycin%2520resistance%2520genes%2520from%2520Enterococcus%2520faecalis%2520could%2520be%2520transferred%2520by%2520horizontal%2520gene%2520transfer%2520to%2520S.%2520aureus%252C%2520conferring%2520high-level%2520vancomycin%2520resistance%2520to%2520S.%2520aureus&f=false|publisher = Horizon Scientific Press|date = 2013|isbn = 9781908230287|first = Thomas|last = Proft}} 11. ^{{Cite book|title = Antimicrobial Resistance in Bacteria|url = https://books.google.com/?id=sQ7URquB4YcC&pg=PT45&dq=Vancomycin-resistant+S.+aureus+++horizontal+gene+transfer#v=onepage&q=Vancomycin-resistant%2520S.%2520aureus%2520%2520%2520horizontal%2520gene%2520transfer&f=false|publisher = Horizon Scientific Press|date = 2007|isbn = 9781904933243|first = Carlos F.|last = Amábile-Cuevas}} 12. ^{{cite journal |author=Courvalin P |title=Vancomycin resistance in gram-positive cocci |journal=Clin. Infect. Dis. |volume=42 Suppl 1 |issue= |pages=S25–34 |date=January 2006 |pmid=16323116 |doi=10.1086/491711 |url=}} 13. ^{{Cite book|title = Emerging Infections in Asia|url = https://books.google.com/?id=5WKoOibILtkC&pg=PA234&dq=heterogeneous+vancomycin-intermediate+S.+aureus#v=onepage&q=heterogeneous%2520vancomycin-intermediate%2520S.%2520aureus&f=false|publisher = Springer Science & Business Media|date = 2008-04-11|isbn = 9780387757216|first = Yichen|last = Lu|first2 = Max|last2 = Essex|first3 = Bryan|last3 = Roberts}} Further reading
External links{{Medical resources| ICD10 = | ICD9 = V09.8 | ICDO = | OMIM = | DiseasesDB = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeSH = | GeneReviewsNBK = | GeneReviewsName = | Orphanet = }}
4 : Staphylococcaceae|Bacterial diseases|Antibiotic-resistant bacteria|Staphylococcus |
| 随便看 |
开放百科全书收录14589846条英语、德语、日语等多语种百科知识，基本涵盖了大多数领域的百科知识，是一部内容自由、开放的电子版国际百科全书。