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ATLANTA -- The Centers for Disease Control and Prevention (CDC) has reported the first case of vanomycin resistance involving the Staphylococcus aureus bacterium, the most common cause of skin infections in the United States.
The case, described in an article in the April 3, 2003 New England Journal of Medicine, is significant because vanomycin is normally considered the most reliable drug for treating these infections, which have demonstrated resistance to other traditional first-line drug treatments for some time.
S. aureus causes a wide range of infections and is commonly found on the skin and in the noses of healthy people. Approximately one-third of people have S. aureus on their bodies at any given time. Nearly all strains of S. aureus in the United States are resistant to penicillin and by the 1970s, methicillin-resistant S. aureus had emerged and spread in health care settings.
The CDC estimates that of approximately 290,000 people hospitalized each year, 120,000 are infected with methicillin-resistant S. aureus (MRSA). In the last five years, community-associated MRSA disease has been recognized in people without exposures to the healthcare setting or previous infection with MRSA. This phenomenon encouraged the widespread use of vancomycin as the preferred treatment because there had been no demonstrated resistance.
"The emergence of VRSA is of great concern to clinicians and public health officials," said CDC director Dr. Julie L. Gerberding. "Although the infection in the patient in this first case was treatable with other antibiotics, these findings remind us of the need for infection control and judicious use of antibiotics in the healthcare setting to prevent antibiotic resistance."
"Preventing the emergence of multidrug-resistant organisms requires a comprehensive approach that integrates the private healthcare and public health systems," said Dr. James M. Hughes, director of CDC's National Center for Infectious Diseases. "CDC has programs, educational campaigns and guidelines to prevent antibiotic resistance, but everyone has a role to play in this effort, including other governmental agencies, state and local public health officials, healthcare facilities, clinicians and patients."
The emergence of VRSA is part of an evolution in drug resistance that has been going on for 50 years. In addition to the Michigan case first reported in July 2002, and discussed in the NEJM, CDC confirmed a second unrelated case of VRSA in Pennsylvania in October 2002. In addition to these two healthcare-associated cases of VRSA, the public health community continues to document the emergence of MRSA in the community.
CDC encourages adherence to recommended prevention and control guidelines, active surveillance to detect the emergence of these infectious organisms, and proper use of antibiotics. To learn more about what CDC is doing to prevent antimicrobial resistance go to: www.cdc.gov/drugresistance.