A modified population analysis profile (PAP) method to detect hetero-resistance to vancomycin in Staphylococcus aureus in a UK hospital
Abstract
One hundred methicillin-resistant Staphylococcus aureus (MRSA) strains, isolated between 1983 and 1999, were tested alongside the vancomycin hetero-resistant S. aureus (hVRSA) strain Mu 3, and vancomycin-resistant S. aureus (VRSA) strain Mu 50, for their resistance to vancomycin. This was achieved using the screening method described by Hiramatsu, gradient plates, agar incorporation, standard Etest, macrodilution Etest and a modified population analysis. Using Hiramatsu's screening method, 5% of the 100 MRSA were identified as VRSA and 5% identified as hVRSA, the gradient plates identified 7% hVRSA, and the standard and macrodilution Etests identified no hVRSA. Mu 3 appeared to be vancomycin-susceptible using both the agar incorporation and standard Etest methods, but was classified as hVRSA using the macrodilution Etest. The modified population analysis reliably detected vancomycin hetero-resistance in Mu 3 and identified no hVRSAs within the 100 MRSA sample.
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The population analysis profile assay is the gold standard for detecting heteroresistance.
“The population analysis profile assay is used as gold standard for detecting heteroresistance [31].”
From Antifungal persistence: Clinical relevance and mechanisms (2025) · cites this paper as [31]
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Bae, I., Federspiel, J. J., Miró, J. M., Woods, C. W., Park, L., Rybak, M. J., Rude, T. H., Bradley, S., Bukovski, S., de la Maria, C. G., et al. (2009) · The Journal of Infectious Diseases · doi:10.1086/606027 · Cited by 122 · see citing works
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Casapao, A. M., Davis, S. L., Barr, V. O., Klinker, K. P., Goff, D. A., Barber, K. E., Kaye, K. S., Mynatt, R. P., Molloy, L. M., Pogue, J. M., et al. (2014) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.02371-13 · Cited by 108 · see citing works
Werth, B. J., Vidaillac, C., Murray, K. P., Newton, K. L., Sakoulas, G., Nonejuie, P., Pogliano, J., & Rybak, M. J. (2013) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.02354-12 · Cited by 69 · see citing works
Escribano, P., Recio, S., Peláez, T., González-Rivera, M., Bouza, E., & Guinea, J. (2012) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.00301-11 · Cited by 48 · see citing works
Antifungal persistence: Clinical relevance and mechanisms
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“The population analysis profile assay is used as gold standard for detecting heteroresistance [31].”
- Authors
- Wootton, M.
- Affiliations
- North Bristol NHS Trust (GB)
- Corresponding author
- Wootton, M.
- ORCID
- Wootton, M.
- Venue
- Journal of Antimicrobial Chemotherapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-04-01
- Volume
- 47
- Issue
- 4
- Pages
- 399-403
- ISSN
- 0305-7453 (ISSN-L)
- 1460-2091
- OpenAlex
- W2163780760
- Cited by
- 414
- References
- 0
- Citations by year
- 2026: 12 · 2025: 6 · 2024: 10 · 2023: 24 · 2022: 13 · 2021: 16 · 2020: 12 · 2019: 15 · 2018: 17 · 2017: 8 · 2016: 23 · 2015: 32 · 2014: 26 · 2013: 20 · 2012: 27
- FWCI
- 6.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Antimicrobial Chemotherapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Keywords
- vancomycin heteroresistance, vancomycin-resistant Staphylococcus aureus, population analysis profile, methicillin-resistant Staphylococcus aureus, E-test, antimicrobial susceptibility testing
- MeSH terms
- United Kingdom, Hospitals, Humans, Microbial Sensitivity Tests, Phenotype, Sensitivity and Specificity, Staphylococcal Infections, Staphylococcus aureus, Vancomycin, Reproducibility of Results, Methicillin Resistance, Vancomycin Resistance
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