Epidemiological and Microbiological Characterization of Infections Caused by Staphylococcus aureus with Reduced Susceptibility to Vancomycin, United States, 1997–2001
Abstract
Infections caused by Staphylococcus aureus with reduced vancomycin susceptibility (SA-RVS; minimum inhibitory concentration [MIC], ≥4 μg/mL), including vancomycin-intermediate S. aureus (VISA; MIC, 8 μg/mL), are a new clinical and public health dilemma. Prospective surveillance and a nested case-control study of patients in the United States infected with SA-RVS was conduced from March 1999 through December 2000. Control patients were persons infected with oxacillin-resistant S. aureus (MIC of vancomycin, <2 μg/mL). Among 19 case patients, 4 infections were due to VISA and 15 were due to non-VISA SA-RVS. Case patients with and those without VISA infection had similar clinical presentations and outcomes; the overall attributable mortality rate was 63%. Isolates recovered from case patients had heterogeneous pulsed-field gel electrophoresis banding patterns, regardless of the MIC of vancomycin. Neither dialysis nor chronic renal failure were predictive of case status compared with control status. Independent risk factors for being a case patient included antecedent vancomycin use and prior oxacillin-resistant S. aureus infection 2 or 3 months before the current infection.
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Increasing rates of oxacillin-resistant S aureus or MRSA isolates in hospital and community settings have complicated the treatment of S aureus infective endocarditis.
“Increasing rates of oxacillin-resistant S aureus or MRSA isolates in both hospital and community settings and the recovery of clinical S aureus isolates both partially and fully 138,139 resistant to vancomycin have complicated the treatment of S aureus IE.”
From Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association (2015) · cites this paper as [139]
The Abstract (page unavailable) describes S. aureus as a cause of community-acquired and health care-associated infections, and the Clinical description study (page unavailable) lists MRSA endocarditis cases. The copy does not establish increasing MRSA rates in either setting or show that those rates complicated treatment of infective endocarditis. (LLM, conf=0.76)
Experimental — accuracy not yet measuredRecovery of clinical S aureus isolates partially and fully resistant to vancomycin has complicated the treatment of S aureus infective endocarditis.
“the recovery of clinical S aureus isolates both partially and fully 138,139 resistant to vancomycin have complicated the treatment of S aureus IE.”
From Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association (2015) · cites this paper as [139]
The Clinical description study reports a vancomycin-intermediate S. aureus (VISA) infection complicated by endocarditis, and Table 1 describes a patient with mitral valve endocarditis who died. The paper also mentions a fully vancomycin-resistant isolate, but not in an endocarditis case; it does not establish that both forms of resistance complicated treatment of S. aureus infective endocarditis. Page numbers were not available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe increase in S aureus infective endocarditis is especially prevalent in North America.
“and is especially prevalent in North America.6,138,139”
From Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association (2015) · cites this paper as [139]
The Clinical description study section reports one US patient whose S. aureus bloodstream infection was complicated by endocarditis. The Discussion addresses the rarity of reduced vancomycin susceptibility, not trends in infective endocarditis. Searches for endocarditis incidence and North American prevalence found no passage establishing that S. aureus infective endocarditis is increasing or especially prevalent in North America; page numbers were unavailable in our copy. (LLM, conf=0.74)
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References 28 · Cited by 344
Research works printed but not linked: 5
- [2]2. Centers for Disease Control and Prevention. National Nosocomial In- fections Surveillance (NNIS) system report, data summary from Jan- uary 1992-June 2001. Am J Infect Control 2001; 29:404-21.
- [3]3. Centers for Disease Control and Prevention. Four pediatric deaths from community-acquired methicillin-resistant Staphylococcus aureus- Minnesota and North Dakota, 1997-1999. MMWR Morb Mortal Wkly Rep 1999; 48:707-10.
- [4]4. Herold BC, Immergluck LC, Maranan MC, et al. Community-acquired methicillin-resistant Staphylococcus aureus in children with no iden- tified predisposing risk. JAMA 1998; 279:593-8.
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- Authors
- Fridkin, S. K., Hageman, J., McDougal, L. K., Mohammed, J., Jarvis, W. R., Perl, T. M., Tenover, F. C., & the Vancomycin‐Intermediate Staphylococcus aureus Epidemiology Study Group
- Affiliations
- Centers for Disease Control and Prevention (US)
- Johns Hopkins University (US)
- Corresponding author
- Fridkin, Scott K.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2003-02-15
- Volume
- 36
- Issue
- 4
- Pages
- 429-439
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2129004019
- Semantic Scholar
- 525d8fef8edfe66d4e3ab4031f2ba2ebe984168c
- Cited by
- 344
- References
- 28
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 6 · 2023: 4 · 2022: 3 · 2021: 4 · 2020: 6 · 2019: 4 · 2018: 3 · 2017: 8 · 2016: 12 · 2015: 21 · 2014: 19 · 2013: 13 · 2012: 21
- FWCI
- 21.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Health and Human Services
- Minnesota Department of Health
- Northwestern University
- Johns Hopkins University
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
- Keywords
- Staphylococcus aureus, reduced vancomycin susceptibility, vancomycin-intermediate Staphylococcus aureus, antimicrobial resistance, risk factors, mortality, dialysis, chronic kidney disease, pulsed-field gel electrophoresis typing, United States
- MeSH terms
- Adult, Aged, Humans, Microbial Sensitivity Tests, Middle Aged, Staphylococcal Infections, Staphylococcus aureus, United States, Vancomycin, Case-Control Studies, Electrophoresis, Gel, Pulsed-Field, Vancomycin Resistance
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