Clinical implications of varying degrees of vancomycin susceptibility in methicillin-resistant Staphylococcus aureus bacteremia

Mitchell J. Schwaber, Sharon B. Wright, Yehuda Carmeli, Lata Venkataraman, Paola C. DeGirolami, Aneta Gramatikova, Trish M. Perl, George Sakoulas, Howard S. Gold

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

We conducted a retrospective study of the clinical aspects of bacteremia caused by methicillin-resistant Staphylococcus aureus (MRSA) with heterogeneously reduced susceptibility to vancomycin. Bloodstream MRSA isolates were screened for reduced susceptibility by using brain-heart infusion agar, including 4 mg/L vancomycin with and without 4% NaCl. Patients whose isolates exhibited growth (case-patients) were compared with those whose isolates did not (controls) for demographics, coexisting chronic conditions, hospital events, antibiotic exposures, and outcomes. Sixty-one (41%) of 149 isolates exhibited growth. Subclones from 46 (75%) of these had a higher MIC of vancomycin than did their parent isolates. No isolates met criteria for vancomycin heteroresistance. No differences in potential predictors or in outcomes were found between case-patients and controls. These data show that patients with vancomycin-susceptible MRSA bacteremia have similar baseline clinical features and outcomes whether or not their bacterial isolates exhibit growth on screening media containing vancomycin.

Original languageEnglish (US)
Pages (from-to)657-664
Number of pages8
JournalEmerging Infectious Diseases
Volume9
Issue number6
DOIs
StatePublished - Jun 1 2003

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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    Schwaber, M. J., Wright, S. B., Carmeli, Y., Venkataraman, L., DeGirolami, P. C., Gramatikova, A., Perl, T. M., Sakoulas, G., & Gold, H. S. (2003). Clinical implications of varying degrees of vancomycin susceptibility in methicillin-resistant Staphylococcus aureus bacteremia. Emerging Infectious Diseases, 9(6), 657-664. https://doi.org/10.3201/eid0906.030001