Heterorogenious vancomycin intermediate Staphylococcus aureus (hVISA) strains are unique which neither complete resistance nor intermediate resistance to vancomycin. Because of such nature of the strain, routine diagnostic lab cannot identify hVISA strains.  Gold standard method for detection of hVISA is population analysis profile –area under curve (PAP-AUC) method and it is cumbersome technique. PAP-AUC method is labour intensive and time consuming (72 hrs).  Detection of hVISA was my one of the objective during my PhD work, Under the guidance of Dr.Sujatha Sistla. Initially we were unable to standardize the technique . After reading published article from Dr. Avinash singh et al.,2015 from SGPGI lucknow I have contacted the authors. Dr. Kashinath Prasad gave me the permission to learn from Dr.Avinash  at SGPGI and he taught me complete procedure. The procedure involves use of graph pad prism software and without guidance it is not possible to implement PAP-AUC method. Since most of them are not aware of this method, published reports from India on hVISA are very few. We have performed PAP-AUC method for all the 500 isolates (2014-2016) even though it is cumbersome technique. We have reported around 12 % of prevalence rate (PMID: 31670275). JIPMER is the nodal coordinating center for antimicrobial resistance surveillance network for Staphylococci and Enterococci. Dr.Sujtha Sistla is the principle investigator. Currently we are also looking for hVISA from 19 centers across India. In the year 2019 the overall rate of hVISA across India is about 6%. There is lack of treatment failure reports from India. It is important to study the rate of hVISA infection from blood and other sterile body sites and look for patients response with the vancomycin treatment. This report will be helpful in assessing patients response from tertiary care hospitals in India. More such studies should come up across India which is lacking at present.

 

Dr.Rajesh.A

Senior research fellow

ICMR-AMRSN-Project

Dept of Microbiology

JIPMER.

 

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