Prevalence and clinical implications of Staphylococcus aureus with a vancomycin MIC of 4 μg/ml in Korea

Hong Bin Kim, Yeong Seon Lee, Bong Su Kim, Jeong Ok Cha, Sung Uk Kwon, Hee Joo Lee, Jin Tae Suh, Insoo Rheem, Jeong Man Kim, Bo Moon Shin, Mi Na Kim, Kyungwon Lee, Chang Seop Lee, Eui Chong Kim, Myoung Don Oh, Kang Won Choe

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Abstract

In addition to vancomycin-intermediate Staphylococcus aureus (VISA), S. aureus with a vancomycin MIC of 4 μg/ml has been reported to be the cause of therapeutic failure. This study was designed to determine the prevalence of methicillin-resistant S. aureus (MRSA) with a vancomycin MIC of 4 μg/ml and to clarify the clinical characteristics of infections caused by these isolates. During the 8-week period from April to May, 2001, 27 hospitals participated in a nationwide surveillance program for VISA and vancomycin-resistant S. aureus (VRSA) in Korea. After screening on brain-heart infusion agar containing 4 μg/ml of vancomycin as previously described, 100 isolates with confluent growth were tested. The medical records of the patients involved were reviewed. Even though VISA or VRSA was not detected among 3,756 MRSA isolates, 18 (0.5%) had a vancomycin MIC of 4 μg/ml The infections in 12 of these patients, excluding 5 that were colonized, were 8 chronic osteomyelitis, 1 surgical site infection, 1 pneumonia, 1 intra-abdominal infection, and 1 catheter-related infection. Although 11 cases were exposed to glycopeptides for a long time (median 56 days), the site of infection became culture-negative in only 1 case. Two patients died of their S. aureus infections. MRSA with a vancomycin MIC of 4 μg/ml was rare. Chronic osteomyelitis was the most common type of infection, and prolonged exposure to glycopeptides was associated with reduced susceptibility to vancomycin.

Original languageEnglish
Pages (from-to)33-38
Number of pages6
JournalMicrobial Drug Resistance
Volume12
Issue number1
DOIs
Publication statusPublished - 2006 Mar

All Science Journal Classification (ASJC) codes

  • Microbiology
  • Immunology
  • Pharmacology
  • Microbiology (medical)

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    Kim, H. B., Lee, Y. S., Kim, B. S., Cha, J. O., Kwon, S. U., Lee, H. J., Suh, J. T., Rheem, I., Kim, J. M., Shin, B. M., Kim, M. N., Lee, K., Lee, C. S., Kim, E. C., Oh, M. D., & Choe, K. W. (2006). Prevalence and clinical implications of Staphylococcus aureus with a vancomycin MIC of 4 μg/ml in Korea. Microbial Drug Resistance, 12(1), 33-38. https://doi.org/10.1089/mdr.2006.12.33