Comparison of method-specific vancomycin minimum inhibitory concentration values and their predictability for treatment outcome of meticillin-resistant Staphylococcus aureus (MRSA) infections
| Autor: | Ryan M. Quist, Donald I. Hsu, Anne Yusof, Annie Wong-Beringer, Janet F. Hindler, Asa Karlsson, Levita Hidayat |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
Methicillin-Resistant Staphylococcus aureus Microbiology (medical) medicine.medical_specialty Meticillin Adolescent Microbial Sensitivity Tests medicine.disease_cause Gastroenterology Microbiology Cohort Studies Young Adult Minimum inhibitory concentration Predictive Value of Tests Vancomycin Internal medicine medicine Humans Pharmacology (medical) Prospective Studies Etest Aged Antibacterial agent business.industry Broth microdilution Vancomycin Resistance General Medicine Middle Aged Staphylococcal Infections biochemical phenomena metabolism and nutrition equipment and supplies bacterial infections and mycoses Anti-Bacterial Agents Phenotype Treatment Outcome Infectious Diseases Staphylococcus aureus Predictive value of tests business medicine.drug |
| Zdroj: | International Journal of Antimicrobial Agents. 32:378-385 |
| ISSN: | 0924-8579 |
| Popis: | The objectives of this study were to examine the predictive value of method-specific vancomycin (VAN) minimum inhibitory concentration (MIC) results on treatment outcomes of meticillin-resistant Staphylococcus aureus (MRSA) infections. VAN MIC values for MRSA strains were determined using Etest, VITEK-1, MicroScan (MScan) and broth microdilution (BMD), with additional screening for heterogeneous glycopeptide-intermediate S. aureus (hGISA) phenotype. Patients' charts were reviewed for outcome correlation. Performance characteristics of method-specific VAN MICs in predicting outcome were compared. Most (76%) of the 92 strains tested caused pneumonia or bacteraemia. The majority of strains tested (>70%) had a VAN MIC >1mg/L by Etest or MScan compared with 41% by Vitek and 7% by BMD. Agreement between test methods for high versus low MICs (>1mg/L vs. < or = 1mg/L) ranged from 36% to 71%. High versus low VAN MICs by Etest differentiated response of invasive strains to VAN. Performance characteristics (sensitivity/specificity/positive predictive value/negative predictive value) were: Etest, 55/81/89/38%; and Vitek, 56/62/81/32/%, respectively. Eight strains (9%) demonstrated a hGISA phenotype; more yielded high MICs by Etest, MScan and Vitek than BMD (87%, 87% and 75% vs. 50%). In conclusion, VAN MIC testing methods produce highly variable results. The Etest method appears to be relatively more reliable in predicting treatment response and yielded higher MICs for strains with a hGISA phenotype. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect