Because the occurrence of fully vancomycin-resistant staphylococcal infection in a hospital could result in serious public health consequences, CDC and the Hospital Infection Control Practices Advisory Committee have developed interim guidelines to direct medical and public health responses when isolates of staphylococci with reduced vancomycin susceptibility are identified. To effectively implement these interim guidelines, each health-care facility should develop a plan based on these guidelines in which responsibilities for critical departments and personnel are clearly delineated.
Antimicrobial use is a major risk factor for the emergence of antimicrobial-resistant pathogens.
Reduction of overuse and misuse of antimicrobials will decrease the risk for emergence of staphylococci with reduced susceptibility to vancomycin. Retest staphylococci isolated from patients who fail to respond to vancomycin therapy because resistance may have emerged during therapy. The susceptibility pattern of a particular staphylococcus strain, the site of infection, and the response to conventional therapy is important in determining the need for investigational antimicrobials to treat infections caused by staphylococci with reduced vancomycin susceptibility. Some of these agents also may be useful in treating infections with S. aureus with reduced susceptibility to vancomycin. The usefulness of any antimicrobial agent will depend on the resistance mechanism and susceptibility pattern of the S. aureus strain.