Vancomycin and daptomycin minimum inhibitory concentrations as a predictor of outcome of methicillin-resistant Staphylococcus aureus bacteraemia
| Autor: | Jesus Ruiz, Esther Villarreal, Monica Gordon, Paula Ramirez, Juan Frasquet, Pablo Concha, Miguel Salavert-Lleti, Álvaro Castellanos-Ortega |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Male Methicillin-Resistant Staphylococcus aureus medicine.medical_specialty Staphylococcus aureus medicine.drug_class 030106 microbiology Immunology Antibiotics Bacteremia Microbial Sensitivity Tests medicine.disease_cause Lower risk Microbiology 03 medical and health sciences Minimum inhibitory concentration Daptomycin Vancomycin Internal medicine medicine Immunology and Allergy Humans Treatment Failure Aged Retrospective Studies business.industry Mortality rate Middle Aged Staphylococcal Infections biochemical phenomena metabolism and nutrition bacterial infections and mycoses Methicillin-resistant Staphylococcus aureus Anti-Bacterial Agents Treatment Outcome Spain Bacteraemia Female business medicine.drug |
| Zdroj: | Journal of Global Antimicrobial Resistance r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname |
| ISSN: | 2213-7165 |
| Popis: | Objectives: The aim of this study was to determine the persistence of the adverse prognostic effect of elevated vancomycin minimum inhibitory concentration (MIC) in methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia in a setting with low vancomycin use. Methods: A retrospective study focusing on episodes of bacteraemia due to MRSA diagnosed from January 2010 through December 2015 was designed. The main outcome measures were 30-day mortality and treatment failure. Multivariate logistic regression analysis was used to identify variables associated with patient mortality and treatment outcome. Results: In total, 79 MRSA bacteraemia episodes were included. The vancomycin MIC was >1.0 mu g/mL in 53 episodes (67.1%). The presence of high vancomycin MIC was not associated with a higher mortality rate or treatment success. A daptomycin MIC >= 0.5 mu g/mL was present in 16 (26.2%) of 61 episodes for which the daptomycin MIC was obtained and was associated with 30-day mortality in the multivariate analysis (odds ratio = 4.72, 95% confidence interval 1.19-18.71). None of the antimicrobials used were associated with a lower risk of treatment failure or mortality. Conclusions: The pernicious effect of high vancomycin MIC disappears in the absence of a predominant use of this antibiotic. However, a high daptomycin MIC in MRSA bacteraemia is associated with higher mortality in patients with bacteraemia, irrespective of antimicrobial treatment choice. (C) 2018 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved. |
| Databáze: | OpenAIRE |
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