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Vancomycin Intermediate Staphylococcus Aureus Infection

What is a vancomycin intermediate staphylococcus aureus infection?

  • Vancomycin intermediate staphylococcus (staf-i-lo-KOK-us) aureus (VISA) infection is a condition caused by bacteria (germs). This infection occurs when bacteria, called Staphylococcus aureus or Staph, becomes resistant (not killed) to the antibiotic medicine vancomycin. The Staph bacteria are commonly found on the skin and in the nose. A person may carry the Staph bacteria but not get infected or sick. When Staph causes an infection, such as pimples or boils, mild antibiotics can easily kill them. Caregivers usually give vancomycin only after the mild antibiotics do not work.
  • With VISA infection, the wrong or frequent use of vancomycin causes the Staph bacteria to become resistant. You may need a higher dose of vancomycin to stop the growth of Staph. This is usually 4 to 8 times the minimum amount needed. Since vancomycin may no longer be effective, VISA may cause severe infections in the body. These may include infections of the skin, blood, lungs, heart, and brain. With proper treatment, you have a greater chance of having a full recovery.

What causes a VISA infection?

You may become sick if you had close physical contact with a person infected with VISA. The Staph bacteria may be found in their mouth, nose, wound, intravenous (IV) lines, or catheter tubes. Infected people who do not wash their hands may spread the bacteria. This may happen when you touch their contaminated (dirty) hands or wound, or an object they recently held. The germ may enter the body through the mouth or nose, or through an opening in the skin. VISA may also be found on the surfaces of bed rails, floors, medical instruments, and toilet handles.

What increases my risk of getting a VISA infection?

The following factors may increase your risk of getting a VISA infection:

  • Antibiotics: Taking strong antibiotics the wrong way may cause the bacteria to develop resistance to the antibiotics. These may include prolonged or frequent use of vancomycin antibiotics.
  • Hospital stay: Having surgery, or being in the ICU. Staying in the hospital too long or sharing a room with a VISA infected patient increases your risk.
  • Lines, tubes, or metal implants: Medical tubes may have been placed into your body, such as IV lines, dialysis or a feeding tube. VISA also likes to live on and around metal implants. Having a urine catheter or other special tubes may also promote a VISA infection.
  • Poor hygiene: Poor hygiene practices may include not washing the hands after caring or visiting a person with VISA infection.
  • Weak immune system: The immune system is the part of your body that fights infection. Having diabetes (high blood sugar) or kidney disease may weaken your immune system. Having surgeries or procedures in the past, such as an organ transplant, may also affect your body defenses.

What problems can a VISA infection cause?

Most VISA infections mainly affect the skin and soft tissues directly under the skin, and may later spread to other organs. Staph may directly attack your organs or release toxins (poisons) to cause damage. You may have any of the following:

  • Bacteremia (blood infection).
  • Heart diseases, such as endocarditis (swelling of the inner lining of the heart).
  • Meningitis (swelling of the coverings of the brain and spine).
  • Osteomyelitis (bone infections) or arthritis (swelling of the joints).
  • Pneumonia (infection and swelling of the lungs).
  • Skin and soft tissue infections, such as an abscess (boils) or cellulitis. These are swelling under the skin that are infected and pus-filled.

What are the signs and symptoms of a VISA infection?

Signs and symptoms may depend on the site of the VISA infection. Skin and soft tissue infections may include redness, pain, swelling, and a warm feeling when touched. These skin and soft tissue infections often lead to more serious VISA infections, such as pneumonia or bacteremia. You may have fever, chills, or body weakness and pain. Cough, chest pain, trouble breathing, and a fast heartbeat may also be present. If you have meningitis, you may have frequent sleepiness, headaches, or a stiff neck. You may also have a rash, vision changes, nausea (upset stomach), or vomiting (throwing up).

How is a VISA infection diagnosed?

Caregivers will need some samples from your skin, wound discharge (pus), or secretions (mucus) from your nose. A sample of your urine or blood may also be sent to a lab for tests. These samples may show what germ is causing your disease and help caregivers know the best treatment for you.

How is a VISA infection treated?

Antibiotic medicines are used to treat VISA infection. These may include adding other antibiotics to kill VISA. If you have any infected tubes, your caregivers may need to remove or replace them. You may also need any of the following:

  • Incision and drainage Caregivers may drain the fluid or pus that has collected in the infected area.
  • Surgery: A surgery may also be done depending on where and how bad your infection is. This may be more likely if you have metal implants in your body. You may also need surgery if the antibiotics are not working. Ask your caregiver for more information about having surgery for treating VISA infection.

How can a VISA infection be prevented?

  • Avoid contact with other people's wounds or materials contaminated from wounds. Clean and cover boils or other wound infections with clean, dry bandages until they are healed. Place used bandages in a sealed plastic bag when throwing them away.
  • Avoid sharing eating or drinking utensils, towels, or other personal items.
  • Limit the use of antibiotics. Ask your caregiver for more information about the proper use of antibiotics.
  • Place contaminated laundry in a plastic bag and use hot water and detergents (soap) when washing them. Dry them in a clothes dryer on the hot setting.
  • Use alcohol or chlorine-based disinfectants (germ killers) when cleaning surfaces. Wear gloves, a mask, or a gown to protect yourself.
  • Wash hands often with soap and warm water. Always wash after using the toilet, after changing a child's diaper, and before preparing or serving food. Germ-killing hand lotion or gel may be used to clean hands if there is no water available.

Where can I find more information?

Having a VISA infection may be life-changing for you and your family. Accepting that you have VISA infection may be hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Contact the following for more information:

  • Centers for Disease Control and Prevention (CDC)
    1600 Clifton Road
    Atlanta , GA 30333
    Phone: 1- 800 - 232-4636
    Web Address:
  • National Institute of Allergy and Infectious Diseases
    NIAID Office of Communications & Government Relations
    5601 Fishers Lane, MSC 9806
    Bethesda, MD 20892-9806
    For deliveries, use Rockville, MD 20852
    Phone: 1- 301 - 496-5717
    Phone: 1- 866 - 284-4107
    Web Address:

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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