Giuseppe
Emeritus
[Source: The Lancet, full text: (LINK). Extract.]
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The Lancet, Early Online Publication, 21 June 2013
doi:10.1016/S0140-6736(13)61219-2
First case of infection with vancomycin-resistant Staphylococcus aureus in Europe
Original Text
Jos? Melo-Cristino a b, Cristina Resina b, Viviana Manuel b, Lu?s Lito b, M?rio Ramirez a
Although vancomycin is often prescribed for the treatment of meticillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant S aureus (VRSA) infections remain rare, with only few cases confirmed worldwide?mostly in the USA. Here, we report the isolation and preliminary characterisation of the first VRSA strain in Europe isolated from a patient in Portugal. A 74-year-old woman with diabetes mellitus, chronic renal failure requiring haemodialysis, and peripheral vascular disease conditioning critical limb ischaemia underwent endovascular revascularisation and amputation of two gangrenous toes. Previous cultures of the wound amputation site revealed Pseudomonas aeruginosa and vancomycin-susceptible MRSA, for which she was treated with vancomycin and amikacin. In May, 2013, a meticillin-resistant VRSA strain was isolated from pus of the toe amputation wound. The minimum inhibitory concentrations for vancomycin and teicoplanin were >256 μg/mL and 24 μg/mL, respectively. Vitek 2 and MicroScan systems both detected VRSA. MALDI-TOF analyses confirmed the identification of S aureus. Vancomycin-resistant Enterococcus faecalis (VRE) and P aeruginosa were also isolated from the same wound.
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a Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; b Centro Hospitalar Lisboa Norte, Lisbon, Portugal
-doi:10.1016/S0140-6736(13)61219-2
First case of infection with vancomycin-resistant Staphylococcus aureus in Europe
Original Text
Jos? Melo-Cristino a b, Cristina Resina b, Viviana Manuel b, Lu?s Lito b, M?rio Ramirez a
Although vancomycin is often prescribed for the treatment of meticillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant S aureus (VRSA) infections remain rare, with only few cases confirmed worldwide?mostly in the USA. Here, we report the isolation and preliminary characterisation of the first VRSA strain in Europe isolated from a patient in Portugal. A 74-year-old woman with diabetes mellitus, chronic renal failure requiring haemodialysis, and peripheral vascular disease conditioning critical limb ischaemia underwent endovascular revascularisation and amputation of two gangrenous toes. Previous cultures of the wound amputation site revealed Pseudomonas aeruginosa and vancomycin-susceptible MRSA, for which she was treated with vancomycin and amikacin. In May, 2013, a meticillin-resistant VRSA strain was isolated from pus of the toe amputation wound. The minimum inhibitory concentrations for vancomycin and teicoplanin were >256 μg/mL and 24 μg/mL, respectively. Vitek 2 and MicroScan systems both detected VRSA. MALDI-TOF analyses confirmed the identification of S aureus. Vancomycin-resistant Enterococcus faecalis (VRE) and P aeruginosa were also isolated from the same wound.
(?)
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a Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; b Centro Hospitalar Lisboa Norte, Lisbon, Portugal
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