The glycopeptides (particularly vancomycin) have been the recommended therapy for serious methicillin‐resistant Staphylococcus aureus (MRSA) infections. The increased incidence of MRSA has led to the frequent use of vancomycin. Unfortunately, with the increased use of vancomycin, isolates of S. aureus have been discovered with reduced susceptibility to vancomycin. Several studies suggest that reduced vancomycin susceptibility is associated with vancomycin treatment failure. Various forms of glycopeptide resistance have appeared in MRSA strains, including high‐level resistance, homogeneous and heterogeneous intermediate resistance. While vancomycin‐resistant S. aureus (VRSA) strains are limited to a handful of reported cases and vancomycin‐intermediate S. aureus (VISA) strains remain rare; heterogeneous VISA (hVISA) strains are more common. This article summarizes the current knowledge regarding the history, definition, mechanisms, detection methods, epidemiology and clinical significance of ‘glycopeptide resistance in S. aureus’ and discusses therapeutic optıons for the treatment of hVISA/VISA infections.
Part of the book: The Rise of Virulence and Antibiotic Resistance in Staphylococcus aureus