Ann Lab Med.  2016 May;36(3):235-243. 10.3343/alm.2016.36.3.235.

Prevalence and Clinical Impact of Heterogeneous Vancomycin-Intermediate Staphylococcus aureus Isolated From Hospitalized Patients

• Koh YR
• Kim KH
• Chang CL
• Yi J

• KMID: 2373533
• DOI: http://doi.org/10.3343/alm.2016.36.3.235

Abstract

BACKGROUND
We estimated the prevalence and clinical impact of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA). The concordance between macromethod and glycopeptide resistance detection (GRD) E tests was determined. In addition, predictors of clinical outcomes in hospitalized patients with S. aureus bacteremia (SAB) or pneumonia (SAP) were evaluated.
METHODS
We obtained 229 consecutive S. aureus isolates from all hospitalized patients at two university hospitals located in Busan and Yangsan, Korea. Standard, macromethod, and GRD E tests were performed. Additionally, we reviewed the medical records of all patients. Among the 229 patients, predictors of clinical outcomes were analyzed for 107 patients with SAB and 39 with SAP.
RESULTS
Among the 229 isolates, 34.5% of S. aureus isolates and 50.7% of methicillin-resistant S. aureus isolates exhibited the hVISA phenotype based on the macromethod E test. hVISA was nearly associated with treatment failure in patients with SAB (P=0.054) and was significantly associated with treatment failure in patients with SAP (P=0.014). However, hVISA was not associated with 30-day mortality in patients with SAB or SAP. The concordance between the macromethod and GRD E tests was 84.2%.
CONCLUSIONS
hVISA is quite common in the southeastern part of Korea. hVISA is associated with treatment failure in patients with SAP.

Keyword

Heterogeneous vancomycin-intermediate Staphylococcus aureus; Macromethod E test; Glycopeptide resistance detection E test; S. aureus bacteremia; S. aureus pneumonia

MeSH Terms

Aged
Anti-Bacterial Agents/*pharmacology/therapeutic use
Bacteremia/drug therapy/epidemiology/microbiology
Drug Resistance, Bacterial/*drug effects
Female
Hospital Mortality
Hospitalization
Humans
Male
Methicillin-Resistant Staphylococcus aureus/drug effects/isolation & purification
Microbial Sensitivity Tests
Middle Aged
Phenotype
Pneumonia/drug therapy/epidemiology/microbiology
Prevalence
Republic of Korea/epidemiology
Staphylococcus aureus/*drug effects/isolation & purification
Teicoplanin/pharmacology
Vancomycin/pharmacology/*therapeutic use
Anti-Bacterial Agents
Teicoplanin
Vancomycin

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