Delaware Division of Public Health (DPH) reports a confirmed case of vancomycin resistant Staphylococcus aureus (VRSA). The 67-year-old patient with multiple co-morbidities is being treated on an outpatient basis. On March 10, 2015, lab tests by the Centers for Disease Control and Prevention (CDC) provided final confirmation of VRSA.
VRSA infections are rare in the United States. This Delaware case represents only the 14th confirmed case of VRSA reported in the U.S. DPH previously reported three cases of VRSA - two in 2010 and one in 2012. The DPH Office of Infectious Disease Epidemiology is investigating this case and possible contacts, following CDC recommendations.
Staphylococcus aureus is an important cause of healthcare and community-associated infections. Diseases associated with this common pathogen range from mild skin and soft tissue infections to potentially fatal systemic infections, and affect individuals of all ages. Previously uniformly susceptible to beta-lactam antibiotics, widespread use of this class of antibiotics led to increased resistance and resultant reliance on vancomycin for treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections. The increased use of vancomycin has resulted in a change in the susceptibility of Staphylococcus aureus to this antibiotic.
The possibility of VRSA should be considered in patients who present with skin infections, bloodstream infections, surgical wound infections, and have history of underlying chronic conditions (such as chronic skin ulcers and diabetes), previous treatment with vancomycin, and history of MRSA or vancomycin resistant enterococcus (VRE) infections.
VRSA is potentially transmissible from person-to-person, but such transmission has not been documented. To date, all patients with confirmed VRSA infections have had significant co-morbidities such as diabetes and renal disease, previous infections with MRSA, invasive procedures and devices, recent hospitalizations and recent exposure to vancomycin and other antimicrobial agents.
Infection control guidelines and practices for healthcare facilities have been published and include the prevention and control of multidrug-resistant organisms (including VRSA) by stringent hand washing, the use of contact precautions, and appropriate antibiotic use.
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