Treatment of methicillin-resistant Staphylococcus aureus infections: Importance of high vancomycin minumum inhibitory concentrations

doi:10.5495/wjcid.v5.i2.14

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World Journal of Clinical Infectious Diseases

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2220-3176

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World J Clin Infect Dis. May 25, 2015; 5(2): 14-29
Published online May 25, 2015. doi: 10.5495/wjcid.v5.i2.14

Treatment of methicillin-resistant Staphylococcus aureus infections: Importance of high vancomycin minumum inhibitory concentrations

Alejandra Morales-Cartagena, Antonio Lalueza, Francisco López-Medrano, Rafael San Juan, José María Aguado

Alejandra Morales-Cartagena, Antonio Lalueza, Francisco López-Medrano, José María Aguado, Rafael San juan, Infectious Diseases Unit, Department of Medicine, University Hospital 12 de Octubre, 28041 Madrid, Spain

Author contributions: Morales-Cartagena A and Lalueza A were the main authors in writing the draft version; López-Medrano F and Aguado JM principal physicians involved in the critical revision of the manuscript; all the authors approved the final version of the manuscript.

Conflict-of-interest: The authors declare no conflicts of interest.

Correspondence to: Dr. Alejandra Morales-Cartagena, Infectious Diseases Unit, Department of Medicine, University Hospital 12 de Octubre, Av. Córdoba km 5.400, 28041 Madrid, Spain. a.morales.cartagena@gmail.com

Telephone: +34-91-3908247 Fax: +34-91-3908112

Received: July 3, 2014
Peer-review started: July 4, 2014
First decision: July 29, 2014
Revised: February 26, 2015
Accepted: March 5, 2015
Article in press: March 9, 2015
Published online: May 25, 2015
Processing time: 319 Days and 18.1 Hours

Core Tip

Core tip: The emergence of increasing vancomycin-resistance in Staphylococcus aureus (SA) isolates, has stirred up the basis of therapeutic approach in staphylococcal infections. Complete vancomycin-resistance is acquired through plasmid transmission of enterococcal gene vanA. However, the development of strains with gradual loss of vancomycin-susceptibility seems to be related to conformational bacterial changes and affects its pathogenicity and even its susceptibility to other antimicrobials (other than vancomycin). It has been observed that the impact of diminished vancomycin susceptibility could not only affect methicillin-resistant SA but has also been related to worse prognosis in methicillin-sensitive SA infections. There is yet much to explore to better define the impact of higher vancomycin minimum inhibitory concentration in staphylococcal infections.