Prevalence and Characteristics of Heteroresistant Vancomycin-Intermediate Staphylococcus aureus Bacteremia in a Tertiary Care Center

Infections with S. aureus with heterogeneous intermediate resistance to vancomycin (hVISA) are occurring more frequently. The detection of these infections, their prevalence, clinical characteristics, and significance are controversial. During 2003 and 2004, all blood culture isolates of methicillin...

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Bibliographic Details
Published in:Journal of Clinical Microbiology 2007-05, Vol.45 (5), p.1511-1514
Main Authors: Maor, Yasmin, Rahav, Galia, Belausov, Natasha, Ben-David, Debby, Smollan, Gill, Keller, Nathan
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - pharmacology
Bacteremia - microbiology
Bacteremia - mortality
Bacterial diseases
Bacterial sepsis
Bacteriology
Biological and medical sciences
Child, Preschool
Female
Fundamental and applied biological sciences. Psychology
Hospitals
Human bacterial diseases
Humans
Infectious diseases
Male
Medical sciences
Methicillin Resistance
Microbiology
Middle Aged
Miscellaneous
Prevalence
Staphylococcal Infections - epidemiology
Staphylococcal Infections - microbiology
Staphylococcus aureus
Staphylococcus aureus - drug effects
Vancomycin Resistance
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Summary:Infections with S. aureus with heterogeneous intermediate resistance to vancomycin (hVISA) are occurring more frequently. The detection of these infections, their prevalence, clinical characteristics, and significance are controversial. During 2003 and 2004, all blood culture isolates of methicillin-resistant Staphylococcus aureus (264 patients) at the Sheba Medical Center, Tel Hashomer, Israel, were assessed for hVISA by using the Etest macromethod. A total of 16 patients (6%) were positive for hVISA. Resistance to teicoplanin alone and to vancomycin alone using the Etest macromethod was found in 14 and 10 patients, respectively. Standard MICs to vancomycin were between 1 to 4 mg/ml. Most of these isolates (12 of 16 [75%]) would have been missed without specific testing. The median number of bacteremic days was 4. Seven patients had positive blood cultures for more than 5 days. Twelve patients died, and for eight of these the deaths were directly related to hVISA sepsis. We found that hVISA bacteremia was prevalent in our institution, and we suggest seeking hVISA in patients with persistent S. aureus bacteremia.
ISSN:0095-1137
1098-660X
1098-5530
DOI:10.1128/JCM.01262-06