CDC: Fully resistant strains may now emerge
Detection, reporting, control stressed
In reporting the first two U.S. cases of vancomycin intermediate-resistant Staphylococcus aureus (VISA), the Centers for Disease Control and Prevention (CDC) in Atlanta re-emphasized the following key recommendations for clinicians and infection control professionals:• The emergence of VISA in the United States suggests that staph strains with full resistance to vancomycin may eventually appear.
• These episodes emphasize the need to enhance laboratory capacity at the hospital and state levels to recognize these strains.
• To accurately detect staph with reduced susceptibility to vancomycin, antimicrobial susceptibility should be determined with a quantitative method (broth dilution, agar dilution, or agar gradient diffusion) using a full 24 hours of incubation at 95° F (35° C).
• To prevent the spread of these organisms within and between facilities, health care providers and facilities are advised to ensure appropriate use of vancomycin. Widespread use of antimicrobials is a major contributing factor in the emergence of vancomycin-resistant organisms.
• Educate personnel who provide direct patient care on the epidemiologic implications of such strains and the infection-control precautions necessary for containment.
• Strictly adhere to and monitor compliance with contact isolation precautions and other recommended infection-control practices. In the first case, spread of VISA to other patients and health-care workers probably was prevented by prompt identification of the isolate and its susceptibility pattern, isolation of the patient while hospitalized, and implementation of recommended infection-control practices.
• The isolation of staph with confirmed or presumptive reduced vancomycin susceptibility should be reported through state and local health departments to the CDC’s Investigation and Prevention Branch, Hospital Infections Program, National Center for Infectious Diseases, Mail Stop E69, 1600 Clifton Road NE, Atlanta, GA 30333. Telephone: (404) 639-6413.
• Physicians treating patients with infections caused by staphylococci with reduced susceptibility to vancomycin can obtain information about investigational drug therapies from the Food and Drug Administration’s Division of Anti-Infective Drug Products, telephone: (301) 827-2120.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content