Clinical features and treatment outcomes of vancomycin-intermediate Staphylococcus aureus (VISA) and heteroresistant vancomycin-intermediate Staphylococcus aureus (hVISA) in a tertiary care institution in Singapore

被引:50
作者
Fong, R. K. C. [1 ]
Low, J. [1 ]
Koh, T. H. [1 ]
Kurup, A. [1 ]
机构
[1] Singapore Gen Hosp, Singapore 0316, Singapore
关键词
REDUCED SUSCEPTIBILITY; RESISTANT; DISSEMINATION; BACTEREMIA; STRAINS; MRSA;
D O I
10.1007/s10096-009-0741-5
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
This retrospective case-control study was undertaken to review the clinical features associated with heteroresistant vancomycin-intermediate Staphylococcus aureus (hVISA) and vancomycin-intermediate S. aureus (VISA) infections and the local impact they have on clinical outcome. Compared with vancomycin-susceptible S. aureus (n = 30), hVISA and VISA infections (n = 10) are found to be associated with a longer period of prior glycopeptide use (P = 0.01), bone/joint (P < 0.01) and prosthetic infections (P = 0.04), as well as treatment failure, as evidenced by longer bacteremic (P < 0.01) and culture positivity (P < 0.01) periods. This was observed to have resulted in longer hospital length of stay (P < 0.01) and total antibiotic therapy duration (P = 0.01). There was, however, no significant difference in the overall patient mortality or the hospitalization cost (P = 0.12) in both groups. Clinicians should be cognizant of the association between hVISA/VISA with high bacterial load deep-seated infections. We recommend targeted and even universal screening for hVISA/VISA in methicillin-resistant S. aureus (MRSA) infections.
引用
收藏
页码:983 / 987
页数:5
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