Report of β-lactam antibiotic–induced vancomycin-resistant Staphylococcus aureus from a university hospital in Egypt

We report a case of hospital-acquired pneumonia that to our knowledge is the first description in Egypt of the emergence of vancomycin (VA)-resistant Staphylococcus aureus due to the concomitant use of β-lactams. The combination of β-lactam antibiotics and VA in the treatment of methicillin-resistant S. aureus must be avoided to refrain from inducing VA resistance; further, if there is coinfection with Gram-negative bacilli, β-lactams must be avoided. If β-lactam antibiotic–induced VA-resistant methicillin-resistant S. aureus is isolated, then β-lactams must be avoided until the organism's sensitivity to VA is restored if VA is the only therapeutic option available.