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Heterogeneous vancomycin-intermediate susceptibility phenotype in bloodstream methicillin-resistant Staphylococcus aureus isolates from an international cohort of patients with infective endocarditis: prevalence, genotype, and clinical significance.

Publication ,  Journal Article
Bae, I-G; Federspiel, JJ; Miró, JM; Woods, CW; Park, L; Rybak, MJ; Rude, TH; Bradley, S; Bukovski, S; de la Maria, CG; Kanj, SS; Korman, TM ...
Published in: J Infect Dis
November 1, 2009

BACKGROUND: The significance of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) is unknown. Using a multinational collection of isolates from methicillin-resistant S. aureus (MRSA) infective endocarditis (IE), we characterized patients with IE with and without hVISA, and we genotyped the infecting strains. METHODS: MRSA bloodstream isolates from 65 patients with definite IE from 8 countries underwent polymerase chain reaction (PCR) for 31 virulence genes, pulsed-field gel electrophoresis, and multilocus sequence typing. hVISA was defined using population analysis profiling. RESULTS: Nineteen (29.2%) of 65 MRSA IE isolates exhibited the hVISA phenotype by population analysis profiling. Isolates from Oceania and Europe were more likely to exhibit the hVISA phenotype than isolates from the United States (77.8% and 35.0% vs 13.9%; P < .001). The prevalence of hVISA was higher among isolates with a vancomycin minimum inhibitory concentration of 2 mg/L (P = .026). hVISA-infected patients were more likely to have persistent bacteremia (68.4% vs 37.0%; P = .029) and heart failure (47.4% vs 19.6%; P = .033). Mortality did not differ between hVISA- and non-hVISA-infected patients (42.1% vs 34.8%, P = .586). hVISA and non-hVISA isolates were genotypically similar. CONCLUSIONS: In these analyses, the hVISA phenotype occurred in more than one-quarter of MRSA IE isolates, was associated with certain IE complications, and varied in frequency by geographic region.

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Published In

J Infect Dis

DOI

EISSN

1537-6613

Publication Date

November 1, 2009

Volume

200

Issue

9

Start / End Page

1355 / 1366

Location

United States

Related Subject Headings

  • Vancomycin Resistance
  • Staphylococcal Infections
  • Prevalence
  • Population Surveillance
  • Phylogeny
  • Phenotype
  • Middle Aged
  • Microbiology
  • Microbial Sensitivity Tests
  • Methicillin-Resistant Staphylococcus aureus
 

Citation

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Bae, I.-G., Federspiel, J. J., Miró, J. M., Woods, C. W., Park, L., Rybak, M. J., … International Collaboration on Endocarditis-Microbiology Investigator, . (2009). Heterogeneous vancomycin-intermediate susceptibility phenotype in bloodstream methicillin-resistant Staphylococcus aureus isolates from an international cohort of patients with infective endocarditis: prevalence, genotype, and clinical significance. J Infect Dis, 200(9), 1355–1366. https://doi.org/10.1086/606027
Bae, In-Gyu, Jerome J. Federspiel, José M. Miró, Christopher W. Woods, Lawrence Park, Michael J. Rybak, Thomas H. Rude, et al. “Heterogeneous vancomycin-intermediate susceptibility phenotype in bloodstream methicillin-resistant Staphylococcus aureus isolates from an international cohort of patients with infective endocarditis: prevalence, genotype, and clinical significance.J Infect Dis 200, no. 9 (November 1, 2009): 1355–66. https://doi.org/10.1086/606027.
Bae I-G, Federspiel JJ, Miró JM, Woods CW, Park L, Rybak MJ, Rude TH, Bradley S, Bukovski S, de la Maria CG, Kanj SS, Korman TM, Marco F, Murdoch DR, Plesiat P, Rodriguez-Creixems M, Reinbott P, Steed L, Tattevin P, Tripodi M-F, Newton KL, Corey GR, Fowler VG, International Collaboration on Endocarditis-Microbiology Investigator. Heterogeneous vancomycin-intermediate susceptibility phenotype in bloodstream methicillin-resistant Staphylococcus aureus isolates from an international cohort of patients with infective endocarditis: prevalence, genotype, and clinical significance. J Infect Dis. 2009 Nov 1;200(9):1355–1366.
Journal cover image

Published In

J Infect Dis

DOI

EISSN

1537-6613

Publication Date

November 1, 2009

Volume

200

Issue

9

Start / End Page

1355 / 1366

Location

United States

Related Subject Headings

  • Vancomycin Resistance
  • Staphylococcal Infections
  • Prevalence
  • Population Surveillance
  • Phylogeny
  • Phenotype
  • Middle Aged
  • Microbiology
  • Microbial Sensitivity Tests
  • Methicillin-Resistant Staphylococcus aureus