Vancomycin-Intermediate Staphylococcus Aureus Infection - Symptoms, Diagnosis, and Treatment

Introduction

Staphylococcus aureus (staph) is a bacteria found on the skin and inside the nose of a healthy individual and often does not cause any disease. However, when these bacteria enter the body through a break in the skin barrier, they can cause infections like pimples or severe conditions such as pneumonia, bloodstream infections, and surgical site infections. For many years antibiotics were used to treat Staphylococcus aureus infections, but the bacteria has started to show resistance to some antibiotics.

What Is a Vancomycin-Intermediate Staphylococcus Aureus Infection?

Vancomycin-intermediate Staphylococcus aureus infection is a condition in which Staphylococcus aureus bacteria become resistant to the antibiotic Vancomycin. With Vancomycin-intermediate Staphylococcus aureus infection, one might require higher doses of Vancomycin to prevent the growth of Staph bacteria; it could be four to eight times the minimum amount required. Vancomycin-intermediate Staphylococcus aureus can cause severe infections in the body. This includes blood, skin, lungs, heart, and brain infections.

The bacteria are classified based on laboratory tests into Vancomycin-intermediate Staphylococcus aureus and Vancomycin-resistant Staphylococcus aureus. Laboratories perform tests on the amount of Vancomycin required to inhibit the growth of the bacteria in a test tube. According to the minimum inhibitory concentration (MIC) or the minimum amount of Vancomycin that inhibits the growth of the bacteria, staph bacteria can be Vancomycin-intermediate Staphylococcus aureus (MIC is 4-8 µg/ml) or VRSA (MIC is ≥16 µg/ml).

How Is a Vancomycin-Intermediate Staphylococcus Aureus Infection Spread?

The staph bacteria may be present in the nose, wounds, mouth, intravenous lines, or catheter tubes of an infected person. People can get infected with direct close contact with an infected person. For example, Vancomycin-intermediate Staphylococcus aureus-infected people who do not wash their hands may spread the disease. One may contract the disease if they touch objects or surfaces that were recently held by an infected person. Touching the hands or a wound of the infected person may also spread the bacteria. The bacteria enter the body through the mouth or the nose or a break in the skin.

What Are the Risk Factors for Getting a Vancomycin-Intermediate Staphylococcus Aureus Infection?

Factors that may increase the risk of getting a Vancomycin-intermediate Staphylococcus aureus infection include:

• Improper Antibiotics Intake: Consuming Vancomycin for a prolonged period or frequent antibiotic use may cause the bacteria to develop resistance to it.

• Nosocomial Spread: A prolonged hospital stay or sharing a room with a Vancomycin-intermediate Staphylococcus aureus-infected person increases the risk of the infection.

• Catheters, Intravenous Lines (IV), or Metal Implants: Vancomycin-intermediate Staphylococcus aureus may live in and around IV lines, catheter tubes, or metal implants. Having them placed in the body could increase the risk of infection.

• Poor Hygiene Practices: Not washing hands after being in close contact with an infected person could increase the risk of infection.

• Underlying Health Conditions: Kidney diseases or diabetes may weaken the immune system and increase the risk of infection.

• Past Surgeries: People who have undergone surgeries or procedures such as organ transplants are at risk of infection.

What Are the Symptoms of a Vancomycin-Intermediate Staphylococcus Aureus Infection?

Most people exposed to Vancomycin-intermediate Staphylococcus aureus might carry them on their skin and nose but not get sick. Some might get sick days, weeks, or months after exposure. The signs and symptoms of a Vancomycin-intermediate Staphylococcus aureus infection may vary depending on the site of infection. Symptoms of skin and soft tissue infections include pain, swelling, redness, and a warm feeling when touched. These may lead to more severe conditions like pneumonia or bacteremia.

Other symptoms include:

• Fever.

• Chills.

• Weakness.

• Pain.

• Cough.

• Chest pain.

• Breathlessness.

• Rapid heartbeat.

What Are the Complications of a Vancomycin-Intermediate Staphylococcus Aureus Infection?

Most Vancomycin-intermediate Staphylococcus aureus infections manifest as skin and soft tissue infections that later spread to other organs. They may also directly attack the organs or release toxins that can cause damage.

The following are the common complications:

• Endocarditis.

• Heart failure.

• Meningitis.

• Osteomyelitis.

• Arthritis.

• Bacteremia.

• Pneumonia.

• Abscesses.

• Cellulitis.

How Is Vancomycin-Intermediate Staphylococcus Aureus Diagnosed?

If a Vancomycin-intermediate Staphylococcus aureus infection is suspected, the healthcare provider would take samples from the skin, wound discharge, or secretions from the nose, and send them to a laboratory for testing. A blood sample and urine sample may also be tested for Vancomycin-intermediate Staphylococcus aureus.

What Is The Treatment For Vancomycin-Intermediate Staphylococcus Aureus Infection?

The food and drug administration (FDA) has approved many drugs effective against Vancomycin-intermediate Staphylococcus aureus infection. If any tubes or catheters are infected, the healthcare provider may need to replace them. The treatment for a Vancomycin-intermediate Staphylococcus aureus infection may also include the following:

• Incision and drainage of fluid or pus accumulated in the infected site.

• Surgical removal if the metal implant in the body is infected. Surgery may also be indicated based on where and how the infection is and if the antibiotics against Vancomycin-intermediate Staphylococcus aureus infection are ineffective.

How Can a Vancomycin-Intermediate Staphylococcus Aureus Infection Be Prevented?

• Do not touch other people’s wounds or materials contaminated with blood.

• Clean boils or wound infections and cover them using a sterile bandage.

• Discard used bandages in a sealed plastic bag.

• Do not share utensils, towels, or other personal items.

• Take antibiotics strictly according to the prescription provided by the healthcare provider.

• Often wash hands with soap and warm water, especially after using the toilet, changing a child’s diaper, taking care of an infected person, and before preparing or having food.

• Wash contaminated laundry using hot water and detergents.

• Use disinfectants when cleaning surfaces.

• Wear gloves before touching a contaminated surface.

Conclusion

Vancomycin-intermediate Staphylococcus aureus infection is a condition caused due to prolonged or frequent use of Vancomycin. The antibiotic-resistant Staphylococcus aureus bacteria are present on the skin, in the nose, and in the wounds of an infected person. The symptoms may not appear for months after the initial exposure until the organism enters the body through a break in the skin. The infections often start as skin or soft tissue infections and later spread to other organs. The condition is treatable using antibiotics effective against Vancomycin-intermediate Staphylococcus aureus and brings about a full recovery. In addition, adhering to proper hand hygiene practices can help protect one from Vancomycin-intermediate Staphylococcus aureus.