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. Export

@article{citeulike:5916863, abstract = {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.}, author = {Bae, In-Gyu G. and Federspiel, Jerome J. and Mir\'{o}, Jos\'{e} M. and Woods, Christopher W. and Park, Lawrence and Rybak, Michael J. and Rude, Thomas H. and Bradley, Suzanne and Bukovski, Suzana and de la Maria, Cristina Garcia G. and Kanj, Souha S. and Korman, Tony M. and Marco, Francesc and Murdoch, David R. and Plesiat, Patrick and Rodriguez-Creixems, Marta and Reinbott, Porl and Steed, Lisa and Tattevin, Pierre and Tripodi, Marie-Fran\c{c}oise F. and Newton, Karly L. and Corey, G. Ralph and Fowler, Vance G. and {International Collaboration on Endocarditis-Microbiology Investigator}}, citeulike-article-id = {5916863}, citeulike-linkout-0 = {http://dx.doi.org/10.1086/606027}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/19811099}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=19811099}, citeulike-linkout-3 = {http://www.journals.uchicago.edu/doi/abs/10.1086/606027}, day = {1}, doi = {10.1086/606027}, issn = {1537-6613}, journal = {The Journal of infectious diseases}, keywords = {ie, mrsa, vcm}, month = {November}, number = {9}, pages = {1355--1366}, posted-at = {2009-10-16 05:16:05}, priority = {2}, title = {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.}, url = {http://dx.doi.org/10.1086/606027}, volume = {200}, year = {2009} }

TY - JOUR ID - citeulike:5916863 L3 - citeulike-article-id:5916863 N2 - 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. IS - 9 JF - The Journal of infectious diseases SN - 1537-6613 EP - 1366 TI - 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. VL - 200 SP - 1355 KW - ie KW - mrsa KW - vcm AU - Bae, In-Gyu AU - Federspiel, Jerome AU - Miró, José AU - Woods, Christopher AU - Park, Lawrence AU - Rybak, Michael AU - Rude, Thomas AU - Bradley, Suzanne AU - Bukovski, Suzana AU - de la Maria, Cristina Garcia AU - Kanj, Souha AU - Korman, Tony AU - Marco, Francesc AU - Murdoch, David AU - Plesiat, Patrick AU - Rodriguez-Creixems, Marta AU - Reinbott, Porl AU - Steed, Lisa AU - Tattevin, Pierre AU - Tripodi, Marie-Françoise AU - Newton, Karly AU - Corey, Ralph AU - Fowler, Vance PY - 2009/11/01/ UR - http://dx.doi.org/10.1086/606027 ER -