Aims: To highlight the challenges involved in diagnosing and managing complicated heterogeneous vancomycin intermediate Staphylococcus aureus (hVISA) infections and to improve clinical recognition of such infections.
Methods: A retrospective review of patients with proven hVISA infections was undertaken in two major referral centres of North Queensland from 2006 to 2010. All isolates had population analysis profiling (PAP) done along with hVISA screening performed by the macro-Etest (MET).
Results: Five patients were identified, two of whom died of hVISA-related sepsis. Their population analysis profiling-area-under-the-curve ratio (PAP-AUC) ranged between 0.96 and 1.43.
Conclusions: The identification of hVISA isolates in the diagnostic laboratory presents specific challenges. Clinical failure with vancomycin or MICs to vancomycin of ≥2 mg/L should alert the laboratory to proceed with the more specific methods of MET and PAP to identify hVISA or VISA isolates. Alternatives to vancomycin are limited and not always efficacious or tolerated.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/PAT.0b013e3283464ca3 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
In vitro efficacy of levonadifloxacin against methicillin-resistant Staphylococcus aureus (MRSA) including hVISA isolates collected across India.
Indian J Med Microbiol
January 2025
Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India; Central Research Lab, Sri Venkateswaraa Medical College Hospital and Research Centre, Ariyur, Puducherry, India. Electronic address:
Background: Vancomycin has been the preferred treatment for MRSA infections. However, newer drugs are necessary due to the increasing prevalence of MRSA isolates that are less susceptible to vancomycin. Levonadifloxacin and its prodrug alalevonadifloxacin, novel quinolones with broad spectrum anti-MRSA activity.
View Article and Find Full Text PDFReduced vancomycin susceptibility in Staphylococcus aureus clinical isolates: a spectrum of less investigated uncertainties.
BMC Infect Dis
October 2024
Medical Microbiology and Immunology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Background: Staphylococcus aureus clinical isolates with vancomycin MICs of 2 µg/ml have been associated with vancomycin therapeutic failure and the heterogenous vancomycin-intermediate S. aureus (hVISA) phenotype. While carriage of van genes has usually been associated with higher level of MIC and frank vancomycin resistance, the unrecognized risk of hetero-resistance is frequently underestimated.
View Article and Find Full Text PDFPresence of multiple van genes among glycopeptide non-susceptible Staphylococcus aureus exhibiting in vitro MIC creep phenomenon: A study from north-east India.
Indian J Med Res
July 2024
Department of Microbiology, Assam University, Assam, India.
Article Synopsis
- The study investigates the rise of vancomycin-resistant Staphylococcus aureus (VRSA) since 2010, finding that 2.4% of S. aureus infections are now VRSA, along with challenges posed by hVISA isolates.
- Researchers analyzed 845 isolates, confirming 246 as S. aureus, with molecular techniques identifying various vancomycin resistance genes, especially vanA, vanB, and vanD.
- Results indicated that a notable percentage (8%) of isolates exhibited glycopeptide non-susceptibility, with some showing a concerning increase in minimum inhibitory concentration (MIC), which could complicate infection control efforts and antibiotic guidelines.
Staphylococcus aureus response and adaptation to vancomycin.
Adv Microb Physiol
July 2024
Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark. Electronic address:
Antibiotic resistance is an increasing challenge for the human pathogen Staphylococcus aureus. Methicillin-resistant S. aureus (MRSA) clones have spread globally, and a growing number display decreased susceptibility to vancomycin, the favoured antibiotic for treatment of MRSA infections.
View Article and Find Full Text PDFRisk factors for vancomycin treatment failure in heterogeneous vancomycin-intermediate bacteremia.
Microbiol Spectr
August 2024
Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Article Synopsis
- The study looked at patients with a serious infection called hVISA who were treated with a medicine called vancomycin and found that a lot of them (78%) didn't get better.
- Older patients and those with serious health problems had a harder time improving compared to younger and healthier patients.
- Researchers discovered that age and how severe the infection was played big roles in whether the treatment worked or not, suggesting doctors should pay extra attention to these factors when treating hVISA infections.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!