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I G Bae, J J Federspiel, J M Miro, C W Woods, L Park, M J Rybak, T H Rude, S Bradley, S Bukovski, l a de, S S Kanj, T M Korman, F Marco, D R Murdoch, P Plesiat, M Rodriguez-Creixems, P Reinbott, L Steed, P Tattevin, M F Tripodi, K L Newton, G R Corey, and J Fowler (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
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October 19, 2009 10:55 AM - EST
The Journal of infectious diseases.
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%; [Formula: see text]). The prevalence of hVISA was higher among isolates with a vancomycin minimum inhibitory concentration of 2 mg/L ([Formula: see text]). hVISA-infected patients were more likely to have persistent bacteremia (68.4% vs 37.0%; [Formula: see text]) and heart failure (47.4% vs 19.6%; [Formula: see text]). Mortality did not differ between h
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