Daptomycin non-susceptibility in vancomycin-intermediate Staphylococcus aureus (VISA) and heterogeneous-VISA (hVISA): implications for therapy after vancomycin treatment failure

被引：77
作者：
Kelley, Peter G. [1 ,2 ]
Gao, Wei [1 ,2 ]
Ward, Peter B. [1 ,2 ]
Howden, Benjamin P. [1 ,2 ,3 ]
机构：
[1] Austin Hlth, Dept Infect Dis, ACIR, Heidelberg, Vic 3084, Australia
[2] Austin Hlth, Dept Microbiol, Heidelberg, Vic 3084, Australia
[3] Univ Melbourne, Dept Microbiol & Immunol, Parkville, Vic 3052, Australia
来源：
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY | 2011年 / 66卷 / 05期
关键词：
staphylococci; vancomycin resistance; daptomycin resistance; antibiotic resistance; RESISTANCE; STRAINS;
D O I：
10.1093/jac/dkr066
中图分类号：
R51 [传染病];
学科分类号：
100401 ;
摘要：
Objectives: The aim of this study was to establish the relationship between reduced vancomycin and daptomycin susceptibility among Australasian vancomycin-intermediate Staphylococcus aureus (VISA) and heterogeneous-VISA (hVISA) isolates from patients never exposed to daptomycin. Methods: Forty-seven stored clinical isolates of hVISA/VISA collected before November 2008 from around Australia and New Zealand were selected. Daptomycin and vancomycin MIC testing was performed using broth microdilution (BMD) and Etest methods. Daptomycin population analysis was performed on a subset of isolates. Results: The percentage of daptomycin non-susceptible isolates was 0% for vancomycin-susceptible S. aureus (VSSA) (Etest and BMD), for hVISA it was 26% by Etest and 15% by BMD, and for VISA 62% by Etest and 38% by BMD. Population analysis profile testing demonstrated daptomycin heteroresistance among the hVISA and VISA strains tested. Conclusions: This is the highest rate of daptomycin non-susceptibility reported among hVISA isolates to date. Clinicians should exhibit caution when using daptomycin in situations where serious hVISA or VISA infection is a possibility.
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收藏
页码：1057 / 1060
页数：4
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