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New York Scott Gottlieb
The Centers for Disease Control and Prevention (CDC) has reported that in summer 2002, a 40 year old Michigan woman became the first person worldwide known to have been infected with a strain of Staphylococcus aureus that was resistant to the antibacterial vancomycin.
The Michigan woman developed foot ulcers and other skin infections after becoming infected with the bacterium following an amputation. She recovered after doctors prescribed a different course of antibiotics. The CDC said the case highlighted the growing problem of antibiotic resistance (New England Journal of Medicine 2003;348:1342-7).
Until recently, vancomycin was the only uniformly effective treatment for staphylococcal infections. In 1997, the first clinical isolate of S aureus with reduced susceptibility to vancomycin was reported, and since June 2002, eight confirmed infections with such strains have been reported in patients in the United States. The minimal inhibitory concentrations of vancomycin (the amount of the antibiotic needed to keep the bacteria from replicating) reported for these isolates are in the intermediate range (8-16 micrograms/ml) according to criteria defined by the National Committee for Clinical Laboratory Standards.
Staphylococcal isolates with reduced susceptibility to glycopeptides, such as vancomycin and teicoplanin, are a serious public health problem because staphylococci frequently show multidrug resistance, and glycopeptides are the only remaining effective drugs. The CDC also confirmed that a second, unrelated vancomycin resistant staphylococcal infection had been confirmed in Pennsylvania several months after the Michigan case.
"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," said Dr Julie Gerberding, director of the CDC.
Nearly all strains of S aureus in the United States are now resistant
to penicillin. Doctors embraced vancomycin in the late 1990s as resistant forms
of the bacterium spread from hospital settings into the community.
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| Collections under
which this article appears:Other
Infectious Diseases Other
Public Health Drugs:
infections International
health |
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