Relevance of vancomycin-intermediate susceptibility and heteroresistance in methicillin-resistant Staphylococcus aureus bacteraemia

Objectives To assess the relevance of vancomycin-intermediate susceptibility (VISA) and heteroresistance (hVISA) in methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia. Methods We determined vancomycin MICs for 371 saved MRSA blood isolates (2002-03; 2005-06) by Etest and broth microdilut...

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Bibliographic Details
Published in:Journal of antimicrobial chemotherapy 2011-07, Vol.66 (7), p.1594-1599
Main Authors: Khatib, Riad, Jose, Jinson, Musta, Adina, Sharma, Mamta, Fakih, Mohamad G., Johnson, Leonard B., Riederer, Kathleen, Shemes, Stephen
Format: Article
Language:English
Subjects:
Adult
Aged
Anti-Bacterial Agents - pharmacology
Anti-Bacterial Agents - therapeutic use
Antibiotics
Antibiotics. Antiinfectious agents. Antiparasitic agents
Bacteremia - drug therapy
Bacteremia - microbiology
Bacterial diseases
Bacterial sepsis
Biological and medical sciences
Chemotherapy
Female
Genotype & phenotype
Human bacterial diseases
Humans
Infectious diseases
Male
Medical sciences
Methicillin-Resistant Staphylococcus aureus - drug effects
Methicillin-Resistant Staphylococcus aureus - isolation & purification
Microbial Sensitivity Tests
Middle Aged
Pharmacology. Drug treatments
Staphylococcal Infections - drug therapy
Staphylococcal Infections - microbiology
Staphylococcal infections, streptococcal infections, pneumococcal infections
Staphylococcus aureus
Staphylococcus infections
Treatment Outcome
Vancomycin - pharmacology
Vancomycin - therapeutic use
Vancomycin Resistance
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Summary:Objectives To assess the relevance of vancomycin-intermediate susceptibility (VISA) and heteroresistance (hVISA) in methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia. Methods We determined vancomycin MICs for 371 saved MRSA blood isolates (2002-03; 2005-06) by Etest and broth microdilution (BMD), screened for hVISA (Etest methods), determined the population analysis profile (PAP)/AUC for isolates with suspected reduced susceptibility (MICs >2 mg/L and/or hVISA-screen-positive versus Mu3 (hVISA control), and stratified patient characteristics and outcome according to susceptibility phenotype: VISA (PAP/AUC >1.3), hVISA (PAP/AUC 0.9-1.3), and susceptible (S-MRSA; PAP/AUC
ISSN:0305-7453
1460-2091
DOI:10.1093/jac/dkr169