Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/10833
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dc.contributor.authorHorne, K C-
dc.contributor.authorHowden, Benjamin P-
dc.contributor.authorGrabsch, Elizabeth A-
dc.contributor.authorGraham, M-
dc.contributor.authorWard, P B-
dc.contributor.authorXie, S-
dc.contributor.authorMayall, Barrie C-
dc.contributor.authorJohnson, Paul D R-
dc.contributor.authorGrayson, M Lindsay-
dc.date.accessioned2015-05-16T00:24:32Z
dc.date.available2015-05-16T00:24:32Z
dc.date.issued2009-06-08-
dc.identifier.citationAntimicrobial Agents and Chemotherapy 2009; 53(8): 3447-52en_US
dc.identifier.otherPUBMEDen
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/10833en
dc.description.abstractAlthough methicillin (meticillin)-resistant Staphylococcus aureus (MRSA) strains with reduced susceptibility to vancomycin (RVS-MRSA; including vancomycin-intermediate S. aureus [VISA] and heterogeneous VISA [hVISA]) have been linked with vancomycin treatment failure, it is unclear whether they are more pathogenic than vancomycin-susceptible MRSA (VS-MRSA). We prospectively assessed patients with clinical MRSA isolates during a 10-month period to determine clinical status (infection versus colonization) and therapeutic outcome before correlating these findings with the results of detailed in vitro assessment of vancomycin susceptibility, including population analysis profile (PAP) testing. hVISA and VISA were defined by standard PAP criteria (area-under-the-curve ratio compared to that of the reference hVISA strain Mu3 [>or=0.9]) and routine CLSI criteria (vancomycin MIC, 4 to 8 microg/ml), respectively. Among the 117 patients assessed, 58 had RVS-MRSA isolates (56 hVISA and 2 VISA) and 59 had VS-MRSA isolates; the patient demographics and comorbidities were similar. RVS-MRSA was associated with a lower rate of infection than VS-MRSA (29/58 versus 46/59; P = 0.003), including a lower rate of bacteremia (3/58 versus 20/59, respectively; P < 0.001). The cure rates in RVS-MRSA and VS-MRSA groups were not statistically different (16/26 versus 31/42; P = 0.43), but the post hoc assessment of treatment regimes and study size made detailed conclusions difficult. The results of the macro method Etest correlated well with the PAP results (sensitivity, 98.3%, and specificity, 91.5%), but broth microdilution and our preliminary RVS-MRSA detection method correlated poorly. All isolates were susceptible to linezolid and daptomycin. These data suggest that detailed prospective laboratory identification of RVS-MRSA isolates may be of limited value and that, instead, such in vitro investigation should be reserved for isolates from patients who are failing appropriate anti-MRSA therapy.en_US
dc.language.isoenen
dc.subject.otherAdolescenten
dc.subject.otherAdulten
dc.subject.otherAgeden
dc.subject.otherAged, 80 and overen
dc.subject.otherFemaleen
dc.subject.otherHumansen
dc.subject.otherMaleen
dc.subject.otherMethicillin-Resistant Staphylococcus aureus.drug effects.physiologyen
dc.subject.otherMicrobial Sensitivity Testsen
dc.subject.otherMiddle Ageden
dc.subject.otherStaphylococcal Infections.drug therapy.microbiology.physiopathologyen
dc.subject.otherStaphylococcus aureus.drug effects.physiologyen
dc.subject.otherTreatment Outcomeen
dc.subject.otherVancomycin.therapeutic useen
dc.subject.otherYoung Adulten
dc.titleProspective comparison of the clinical impacts of heterogeneous vancomycin-intermediate methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-susceptible MRSA.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleAntimicrobial Agents and Chemotherapyen_US
dc.identifier.affiliationInfectious Diseasesen_US
dc.identifier.doi10.1128/AAC.01365-08en_US
dc.description.pages3447-52en
dc.relation.urlhttps://pubmed.ncbi.nlm.nih.gov/19506056en
dc.type.contentTexten_US
dc.type.austinJournal Articleen
local.name.researcherGrabsch, Elizabeth A
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairetypeJournal Article-
crisitem.author.deptInfectious Diseases-
crisitem.author.deptMicrobiology-
crisitem.author.deptInfectious Diseases-
crisitem.author.deptInfectious Diseases-
crisitem.author.deptInfectious Diseases-
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