Predictors of persistent methicillin-resistant Staphylococcus aureus bacteraemia in patients treated with vancomycin

被引:78
|
作者
Yoon, Young Kyung [1 ]
Kim, Jeong Yeon [1 ]
Park, Dae Won [1 ,2 ]
Sohn, Jang Wook [1 ,2 ]
Kim, Min Ja [1 ,2 ]
机构
[1] Korea Univ, Coll Med, Dept Internal Med, Div Infect Dis, Seoul 136705, South Korea
[2] Korea Univ, Coll Med, Inst Emerging Infect Dis, Seoul 136705, South Korea
关键词
risk factors; minimum inhibitory concentration; case-control study;
D O I
10.1093/jac/dkq050
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
The high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) coupled with an increase in vancomycin use have induced vancomycin tolerance in MRSA, adversely affecting the outcome of MRSA bacteraemia. This study aimed to identify predictors of persistent MRSA bacteraemia (PMRSAB) in patients treated with vancomycin. A retrospective, case-control study was performed at a university hospital in Korea from January 2006 to February 2009. Subjects included 96 patients who had MRSA bacteraemia and received vancomycin under therapeutic drug monitoring. We compared the clinical characteristics, management and outcomes of cases with PMRSAB (>= 7 days, n = 31) with controls with non-PMRSAB (< 3 days, n = 32). Vancomycin MICs were determined by the Vitek 2 system. Of 96 patients with MRSA bacteraemia, MRSA isolates from 21 patients (21.9%) showed a vancomycin MIC of 2 mg/L. Independent predictors of PMRSAB were: retention of implicated medical devices [odds ratio (OR), 10.35; 95% confidence interval (CI), 1.03-104.55]; MRSA infection of at least two sites (OR, 10.24; 95% CI, 1.72-61.01); and vancomycin MIC of 2 mg/L (OR, 6.34; 95% CI, 1.21-33.09). The frequency of side effects and mean trough serum vancomycin concentrations were not significantly different between the two groups. Sixteen patients with PMRSAB subsequently received teicoplanin +/- arbekacin, linezolid or quinupristin/dalfopristin, due to vancomycin failure or intolerance. To minimize the risk of PMRSAB, early removal of implicated devices and evaluation for metastatic infections should be encouraged. Alternative antibiotic therapy is warranted for infections due to isolates with elevated vancomycin MICs, as well as for the high rates of side effects.
引用
收藏
页码:1015 / 1018
页数:4
相关论文
共 50 条
  • [1] Nephrotoxicity of vancomycin in patients with methicillin-resistant Staphylococcus aureus bacteraemia
    Shen, Wan-Chen
    Chiang, Yi-Chun
    Chen, Hsiang-Yin
    Chen, Tso-Hsiao
    Yu, Fang-Lan
    Tang, Chao-Hsiun
    Sue, Yuh-Mou
    NEPHROLOGY, 2011, 16 (08) : 697 - 703
  • [2] Predictors of high vancomycin MIC values among patients with methicillin-resistant Staphylococcus aureus bacteraemia
    Lodise, T. P.
    Miller, C. D.
    Graves, J.
    Evans, A.
    Graffunder, E.
    Helmecke, M.
    Stellrecht, K.
    JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2008, 62 (05) : 1138 - 1141
  • [3] Treatment strategies for persistent methicillin-resistant Staphylococcus aureus bacteraemia
    Lewis, Paul O.
    Heil, Emily L.
    Covert, Kelly L.
    Cluck, David B.
    JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS, 2018, 43 (05) : 614 - 625
  • [4] Microbiological effects of prior vancomycin use in patients with methicillin-resistant Staphylococcus aureus bacteraemia
    Moise, Pamela A.
    Smyth, Davida S.
    El-Fawal, Nadia
    Robinson, D. Ashley
    Holden, Patricia N.
    Forrest, Alan
    Sakoulas, George
    JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2008, 61 (01) : 85 - 90
  • [5] Emergence of resistance to daptomycin in a cohort of patients with methicillin-resistant Staphylococcus aureus persistent bacteraemia treated with daptomycin
    Gasch, O.
    Camoez, M.
    Dominguez, M. A.
    Padilla, B.
    Pintado, V.
    Almirante, B.
    Martin, C.
    Lopez-Medrano, F.
    Ruiz de Gopegui, E.
    Blanco, J. R.
    Garcia-Pardo, G.
    Calbo, E.
    Montero, M.
    Granados, A.
    Jover, A.
    Duenas, C.
    Pujol, M.
    JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2014, 69 (02) : 568 - 571
  • [6] Persistent bacteraemia due to methicillin-resistant Staphylococcus aureus with reduced susceptibility to vancomycin in a patient with erythrodermic psoriasis
    Bakri, Faris G.
    Abu Al-Hommos, Nisreen
    Shehabi, Asem
    Naffa, Randa G.
    Cui, Longzhu
    Hiramatsu, Keiich
    SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES, 2007, 39 (05) : 457 - 460
  • [7] Vancomycin plus ceftaroline for persistent methicillin-resistant Staphylococcus aureus bacteremia
    Kufel, Wesley D.
    Parsels, Katie A.
    Blaine, Bruce E.
    Steele, Jeffrey M.
    Mahapatra, Rahul
    Paolino, Kristopher M.
    Thomas, Stephen J.
    PHARMACOTHERAPY, 2023, 43 (01): : 15 - 23
  • [8] Phenotypic changes of methicillin-resistant Staphylococcus aureus during vancomycin therapy for persistent bacteraemia and related clinical outcome
    Kim, T.
    Kim, E. S.
    Park, S. Y.
    Sung, H.
    Kim, M. -N.
    Kim, S. -H.
    Lee, S. -O.
    Choi, S. -H.
    Jeong, J. -Y.
    Woo, J. H.
    Chong, Y. P.
    Kim, Y. S.
    EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2017, 36 (08) : 1473 - 1481
  • [9] Phenotypic changes of methicillin-resistant Staphylococcus aureus during vancomycin therapy for persistent bacteraemia and related clinical outcome
    T. Kim
    E. S. Kim
    S. Y. Park
    H. Sung
    M.-N. Kim
    S.-H. Kim
    S.-O. Lee
    S.-H. Choi
    J.-Y. Jeong
    J. H. Woo
    Y. P. Chong
    Y. S. Kim
    European Journal of Clinical Microbiology & Infectious Diseases, 2017, 36 : 1473 - 1481
  • [10] agr functionality affects clinical outcomes in patients with persistent methicillin-resistant Staphylococcus aureus bacteraemia
    C. K. Kang
    Y. K. Kim
    S.-I. Jung
    W. B. Park
    K.-H. Song
    K.-H. Park
    P. G. Choe
    H.-C. Jang
    S. Lee
    Y.-S. Kim
    Y. G. Kwak
    K. T. Kwon
    S. Kiem
    C.-J. Kim
    E. S. Kim
    H. B. Kim
    European Journal of Clinical Microbiology & Infectious Diseases, 2017, 36 : 2187 - 2191