We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Is reduced vancomycin susceptibility a factor associated with poor prognosis in MSSA bacteraemia?
- Authors
López-Cortés, L. E.; Velasco, C.; Retamar, P.; del Toro, M. D.; Gálvez-Acebal, J.; de Cueto, M.; García-Luque, I.; Caballero, F. J.; Pascual, A.; Rodríguez-Baño, J.
- Abstract
Objectives: The known data about the influence of vancomycin MIC on Staphylococcus aureus bacteraemia are contradictory. Our objective was to study the possible impact of vancomycin MIC ≥1.5 mg/L on short- and medium-term mortality. Methods: A prospective cohort study was carried out from March 2008 to January 2011 on adult patients with MSSA bacteraemia admitted to a tertiary hospital located in Seville (Spain).We studied the relationship between vancomycin MIC, accessory gene regulator (agr) type and absence of d-haemolysin and poor prognosis. All isolates were genotyped by PFGE. Multivariate analysis, including a propensity score for having a vancomycin MIC of ≥1.5 mg/L, was performed by Cox regression. Results: One hundred and thirty-five episodes of bacteraemia due to MSSA were included in the analysis. Twenty- nine (21.5%) isolates had a vancomycin MIC of ≥1.5 mg/L by Etest. There were no differences in agr distribution or absence of d-haemolysin between isolates with reduced vancomycin susceptibility (RVS) and those without. RVS was not more frequent in specific clones; RVS was not associated with higher 14 or 30 day crude mortality (relative risk=0.44, 95% CI=0.14-1.35; and relative risk=1.01, 95% CI=0.52-1.96) rates, and it did not show higher rates of complicated bacteraemia (14.2% versus 13.8%, P=0.61). Cox regression analysis did not significantly modify the results for 14 day mortality (HR=0.39, 95% CI=0.11-1.34) or 30 day mortality (HR=0.89, 95% CI=0.39-2.04). Conclusions: Contrary to previously published data, we did not find a relationship between RVS and higher mortality in patients with MSSA bacteraemia and we did not find a link with higher complicated bacteraemia rates.
- Subjects
VANCOMYCIN resistance; BACTEREMIA; STAPHYLOCOCCUS aureus; MICROBIAL virulence; MICROBIAL invasiveness; PROGNOSIS
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2015, Vol 70, Issue 9, p2652
- ISSN
0305-7453
- Publication type
Article
- DOI
10.1093/jac/dkv133