Prevalence and management of vancomycin non-susceptible Staphylococcus aureus: A narrative review.

Staphylococcus aureus has long been recognized as an important human pathogen and can cause diseases ranging from asymptomatic colonization to severe and even fatal infections. It readily acquires resistance to multiple classes of antimicrobial agents through chromosomal mutations or the horizontal transfer of resistance determinants. Vancomycin has long been a drug of choice for the treatment of S. aureus and other Gram-positive bacterial infections. However, cases of vancomycin treatment failure have subsequently been reported. Consequently, vancomycin-nonsusceptible S. aureus (VNsSA) has emerged as a significant clinical concern that requires careful attention. This review summarizes the prevalence of VNsSA, the mechanisms underlying vancomycin resistance, methods for its detection, and the associated clinical challenges and current treatment strategies, based on a literature search of PubMed Central (PMC) covering the period from 1997 to 2025.