Inaba Y, Hiramatsu K
Juntendo University, Department of Bacteriology.
Nihon Rinsho. 1998 Oct;56(10):2699-705.
Vancomycin-resistant MRSA (VRSA with MIC > or = 8 mg/L) has been described, recently. Although the incidence of VRSA has been low in Japanese MRSA strains, hetero-VRSA (heterogeneously resistant VRSA with MIC levels of 2-4 mg/L) is found in considerable abundance in Japanese hospitals, that may explain fairly frequent therapeutic failure in the vancomycin treatment of MRSA infection. Hetero-VRSA may also serve as precursor for VRSA in some clinical settings where it is exposed to high concentrations (8 mg/L or above) of vancomycin.
耐万古霉素的耐甲氧西林金黄色葡萄球菌(最低抑菌浓度[MIC]≥8mg/L的VRSA)最近已有报道。尽管日本的耐甲氧西林金黄色葡萄球菌菌株中VRSA的发生率较低,但异质性VRSA(MIC水平为2-4mg/L的异质性耐药VRSA)在日本医院中大量存在,这可能是耐甲氧西林金黄色葡萄球菌感染万古霉素治疗中相当频繁的治疗失败的原因。在某些临床环境中,当异质性VRSA暴露于高浓度(8mg/L及以上)的万古霉素时,它也可能成为VRSA的前体。