Epidemiological and microbiological characterization of infections caused by Staphylococcus aureus with reduced susceptibility to vancomycin, United States, 1997-2001

Scott K. Fridkin, Jeff Hageman, Linda K. McDougal, Jasmine Mohammed, William R. Jarvis, Trish M. Perl, Fred C. Tenover

Research output: Contribution to journalArticle

276 Citations (Scopus)

Abstract

Infections caused by Staphylococcus aureus with reduced vancomycin susceptibility (SA-RVS; minimum inhibitory concentration [MIC], ≥4 μg/mL), including vancomycin-intermediate S. aureus (VISA; MIC, 8 μg/mL), are a new clinical and public health dilemma. Prospective surveillance and a nested case-control study of patients in the United States infected with SA-RVS was conduced from March 1999 through December 2000. Control patients were persons infected with oxacillin-resistant S. aureus (MIC of vancomycin, ≤2 μg/mL). Among 19 case patients, 4 infections were due to VISA and 15 were due to non-VISA SA-RVS. Case patients with and those without VISA infection had similar clinical presentations and outcomes; the overall attributable mortality rate was 63%. Isolates recovered from case patients had heterogeneous pulsed-field gel electrophoresis banding patterns, regardless of the MIC of vancomycin. Neither dialysis nor chronic renal failure were predictive of case status compared with control status. Independent risk factors for being a case patient included antecedent vancomycin use and prior oxacillin-resistant S. aureus infection 2 or 3 months before the current infection.

Original languageEnglish (US)
Pages (from-to)429-439
Number of pages11
JournalClinical Infectious Diseases
Volume36
Issue number4
DOIs
StatePublished - Feb 15 2003

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Vancomycin
Staphylococcus aureus
Microbial Sensitivity Tests
Infection
Oxacillin
Pulsed Field Gel Electrophoresis
Chronic Kidney Failure
Case-Control Studies
Dialysis
Public Health
Mortality

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Epidemiological and microbiological characterization of infections caused by Staphylococcus aureus with reduced susceptibility to vancomycin, United States, 1997-2001. / Fridkin, Scott K.; Hageman, Jeff; McDougal, Linda K.; Mohammed, Jasmine; Jarvis, William R.; Perl, Trish M.; Tenover, Fred C.

In: Clinical Infectious Diseases, Vol. 36, No. 4, 15.02.2003, p. 429-439.

Research output: Contribution to journalArticle

Fridkin, Scott K. ; Hageman, Jeff ; McDougal, Linda K. ; Mohammed, Jasmine ; Jarvis, William R. ; Perl, Trish M. ; Tenover, Fred C. / Epidemiological and microbiological characterization of infections caused by Staphylococcus aureus with reduced susceptibility to vancomycin, United States, 1997-2001. In: Clinical Infectious Diseases. 2003 ; Vol. 36, No. 4. pp. 429-439.
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