Impact of reduced vancomycin susceptibility on the therapeutic outcome of MRSA bloodstream infections

• Main Authors: Cui Longzhu (Author), Takeuchi Fumihiko (Author), Oguri Toyoko (Author), Komatsu Mitsutaka (Author), Hori Satoshi (Author), Neoh Hui-min (Author), Hiramatsu Keiichi (Author)
• Format: Book
• Published: BMC, 2007-10-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to determine whether clinical outcome of patients with methicillin-resistant <it>Staphylococcus aureus </it>(MRSA) bacteraemia was correlated with vancomycin susceptibility of the corresponding strains.</p> <p>Methods</p> <p>A retrospective study on MRSA bacteraemia was performed at a teaching hospital between January 1998 and October 2005 by linking vancomycin susceptibility profiles of patients' isolates with hospitalization data.</p> <p>Results</p> <p>A total of 20 out of 209 MRSA bacteraemia patients were treated with vancomycin for at least 5 days with adequate trough levels, and fulfilled the study's inclusion and exclusion criteria. Twenty-two <it>S. aureus </it>isolates from these patients' blood cultures were identified as MRSA, including two <it>hetero</it>-VISA from separate patients and two VISA with vancomycin MIC of 4 mg/L from one patient. Between patients who showed 'good' vancomycin response and patients who did not, there was a significant difference (p < 0.01) in their corresponding MRSAs' vancomycin susceptibility expressed by 'area under curve' (AUC) of population analysis. Significant correlations were found between AUC and initial vancomycin therapeutic response parameters of 'days till afebrile' (<it>r </it>= 0.828, p < 0.01) and 'days till CRP ≦ 30% of maximum' (<it>r </it>= 0.627, p < 0.01)</p> <p>Conclusion</p> <p>Our study results caution healthcare personnel that early consideration should be given to cases with a poor vancomycin treatment response that could signify the involvement of MRSA with reduced susceptibility to vancomycin.</p>

Item Description

10.1186/1476-0711-6-13
1476-0711