Background: Heteroresistant vancomycin-intermediate Staphylococcus aureus (hVISA) infections are emerging, but their clinical significance remains unclear. Our objective was to compare patients who had hVISA bacteremia with patients who had methicillin-resistant S. aureus (MRSA) bacteremia.
Methods: A total of 27 case patients with hVISA bacteremia were compared with 223 control patients with MRSA bacteremia. Medical records of all patients were reviewed, and factors independently associated with infection-related mortality were assessed by logistic regression.
Results: Patients with hVISA bacteremia were not significantly different from those with MRSA bacteremia with respect to age, comorbidities, duration of hospital stay, and infection-attributable mortality. However, the median duration of bacteremia among patients with hVISA was significantly longer than that among patients with MRSA (12 vs. 2 days; P = .005), and patients with hVISA had a greater prevalence of complications, such as endocarditis (18.5% vs. 3.6%; P = .007) and osteomyelitis (25.9% vs. 7.2%, respectively; P = .006). Rifampin resistance emerged more frequently among hVISA isolates than among MRSA isolates (44% vs. 5.9%; P < .001). Factors independently associated with infection-related mortality in all patients were age, Charlson comorbidity index, female sex, and being bedridden.
Conclusions: hVISA bacteremia was significantly associated with prolonged bacteremia duration, greater rates of complications, and emergence of rifampin resistance, compared with MRSA bacteremia. However, no significant difference in mortality existed between patients with hVISA bacteremia and those with MRSA bacteremia.
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http://dx.doi.org/10.1086/596629 | DOI Listing |
Microbiol Spectr
August 2024
Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
J Glob Antimicrob Resist
June 2024
Department of Microbiology and Virology, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran; Bio Environmental Health Hazards Research Center, Jiroft University of Medical Sciences, Jiroft, Iran. Electronic address:
Background: Heterogeneous vancomycin-intermediate Staphylococcus aureus is considered one of the main causes in treatment failure of vancomycin, which leads to poor clinical outcomes. Herein, we comprehensively evaluated characteristics such as global prevalence, trend, and genetic backgrounds of these strains.
Methods: In this study, we conducted a meta-analysis based on PRISMA checklist 2020.
Sultan Qaboos Univ Med J
November 2023
Department of Microbiology, Kasturba Medical College, Mangalore, (A constituent unit of Manipal Academy of Higher Education, Manipal), Karnataka, India.
Objectives: This study aimed to detect heterogeneous vancomycin-intermediate (hVISA) among methicillin-resistant (MRSA) isolated from healthcare-associated infections and identify staphylococcal cassette chromosome (SCC) types.
Methods: This study was conducted from February 2019 to March 2020 and included patients admitted in 4 tertiary care hospitals in Karnataka, India. Isolation and identification of MRSA were done using standard bacteriological methods.
Braz J Microbiol
March 2024
Clinical Laboratory Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Strain C1 was successfully isolated from an immunosuppressed patient with persistent bacteremia, who had not previously been exposed to glycopeptide antibiotics. This strain was found to be a heterogeneous vancomycin intermediate-resistant Staphylococcus aureus (hVISA). It is noteworthy that, following a brief period of vancomycin treatment, strains C6, C8, and C9, which were obtained from blood and other body parts, exhibited a significant reduction in heterogeneity as determined by population analysis profile-area under the curve (PAP-AUC) detection.
View Article and Find Full Text PDFInfect Drug Resist
January 2023
Department of Laboratory Medicine, Binzhou Medical University Hospital, Binzhou, People's Republic of China.
Objective: To investigate the molecular epidemiology of () isolated from patients in the Yellow River Delta region and to construct antibiotic resistance profiles in different genetic backgrounds.
Methods: Antibiotics susceptibility testing, staphylococcal protein A () typing and accessory gene regulator () typing were performed for all the 204 strains. Isolates with the positive gene and heterogeneous vancomycin-intermediate (hVISA) were subjected to multilocus sequence typing (MLST) and Staphylococcal chromosomal cassettes (SCC) typing.
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