Abstract
A vancomycin-intermediate Staphylococcus aureus (VISA) outbreak occurred in an intensive care unit (ICU) in South Korea. We aimed to investigate the condition that led to the VISA outbreak and seek measures to prevent further spread of the multidrug-resistant organism. A total of three VISA isolates were obtained from two patients and a health care worker (HCW) in a newly built 450-bed secondary hospital. Extensive screening of close contacts for VISA in terms of space sharing and physical contact, irrespective of contact time, was performed. Furthermore, multilocus sequence type, staphylococcal cassette chromosome mec type, and spa type profiles were determined for all VISA isolates. The relationship between vancomycin use and the minimum inhibitory concentration (MIC) of S. aureus was also investigated. Molecular typing showed that the strains of the three VISA isolates were identical, indicating horizontal hospital transmission. We assumed that VISA colonised in the HCW could have transmitted to the two patients, which resulted in one infection and one colonisation. The affected HCW was excused from work and was decolonised with mupirocin. Five weeks after the interventions, no additional VISA isolates were identified. No relationship between vancomycin use and MIC of S. aureus was identified. Extensive screening of contacts in addition to decolonisation is crucial in preventing the further spread of VISA.
Highlights
Antimicrobial resistance (AMR) is a global concern threatening public health
Based on the lessons learned from this experience, we aimed to investigate the conditions that lead to vancomycin-intermediate Staphylococcus aureus (VISA) outbreaks and to identify efficient m2e.1a.suCrleinsictoalpCrheavreancttefruisrttihces rofspSruebajedctosfwthiteh mVaunltciodmruygci-nr-eIsnistetarmntedoiragteanSitsamph.ylococcus aureus Isolates
We demonstrated an association between the amount of vancomycin consumption and the vancomycin minimum inhibitory concentration (MIC) of S. aureus
Summary
Antimicrobial resistance (AMR) is a global concern threatening public health. Infections caused by bacteria with AMR increase the risk of death and the costs of health care [1]. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major pathogens with AMR that infects humans. Vancomycin has been used as the first-choice drug to treat MRSA infection for decades. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major pathogens with. With the spread of MRSA infection worldwide, the empirical use of vancomycin has increased [2]. In South Korea, VISA was first isolated in 1998. Based on the lessons learned from this experience, we aimed to investigate the conditions that lead to VISA outbreaks and to identify efficient m2e.1a.suCrleinsictoalpCrheavreancttefruisrttihces rofspSruebajedctosfwthiteh mVaunltciodmruygci-nr-eIsnistetarmntedoiragteanSitsamph.ylococcus aureus Isolates. 2. ResDulutsring the study period, three VISA isolates were obtained from two patients and 2.o1n. 66 Male Sputum Acute myeloid leukaemia, pneumonia Previous vancomycin use, indwelling medical devices Presence of infection Died
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