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Prevalence and clinical implications of Staphylococcus aureus with a vancomycin MIC of 4 microg/ml in Korea

Cited 11 time in Web of Science Cited 10 time in Scopus
Authors
Kim, Hong Bin; Lee, Yeong Seon; Kim, Bong Su; Cha, Jeong Ok; Kwon, Sung Uk; Lee, Hee Joo; Suh, Jin Tae; Rheem, Insoo; Kim, Jeong Man; Shin, Bo-Moon; Kim, Mi-Na; Lee, Kyungwon; Lee, Chang Seop; Kim, Eui-Chong; Oh, Myoung-Don; Choe, Kang Won
Issue Date
2006-04-06
Publisher
Mary Ann Liebert
Citation
Microb Drug Resist. 2006 Spring;12(1):33-8.
Keywords
Anti-Bacterial Agents/*pharmacologyElectrophoresis, Gel, Pulsed-FieldHumansMethicillin ResistanceMicrobial Sensitivity TestsStaphylococcus aureus/*drug effects/geneticsVancomycin/*pharmacologyVancomycin Resistance
Abstract
In addition to vancomycin-intermediate Staphylococcus aureus (VISA), S. aureus with a vancomycin MIC of 4 microg/ml has been reported to be the cause of therapeutic failure. This study was designed to determine the prevalence of methicillin-resistant S. aureus (MRSA) with a vancomycin MIC of 4 microg/ml and to clarify the clinical characteristics of infections caused by these isolates. During the 8-week period from April to May, 2001, 27 hospitals participated in a nationwide surveillance program for VISA and vancomycin-resistant S. aureus (VRSA) in Korea. After screening on brain-heart infusion agar containing 4 microg/ml of vancomycin as previously described, 100 isolates with confluent growth were tested. The medical records of the patients involved were reviewed. Even though VISA or VRSA was not detected among 3,756 MRSA isolates, 18 (0.5%) had a vancomycin MIC of 4 microg/ml. The infections in 12 of these patients, excluding 5 that were colonized, were 8 chronic osteomyelitis, 1 surgical site infection, 1 pneumonia, 1 intra-abdominal infection, and 1 catheter-related infection. Although 11 cases were exposed to glycopeptides for a long time (median 56 days), the site of infection became culture-negative in only 1 case. Two patients died of their S. aureus infections. MRSA with a vancomycin MIC of 4 microg/ml was rare. Chronic osteomyelitis was the most common type of infection, and prolonged exposure to glycopeptides was associated with reduced susceptibility to vancomycin.
ISSN
1076-6294 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16584306

https://hdl.handle.net/10371/35550
DOI
https://doi.org/10.1089/mdr.2006.12.33
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Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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