Hostname: page-component-848d4c4894-sjtt6 Total loading time: 0 Render date: 2024-06-15T05:09:20.710Z Has data issue: false hasContentIssue false
  • English
  • Français

Prior Vancomycin Use Is a Risk Factor for Reduced Vancomycin Susceptibility in Methicillin-Susceptible but Not Methicillin-Resistant Staphylococcus aureus Bacteremia

Published online by Cambridge University Press:  02 January 2015

Kara B. Mascitti ,
Paul H. Edelstein ,
Neil O. Fishman ,
Knashawn H. Morales ,
Andrew J. Baltus  and
Ebbing Lautenbach
Kara B. Mascitti*
Affiliation:
Division of Infectious Diseases, Department of Medicine, St. Luke's Hospital and Health Network, Bethlehem, Pennsylvania
Paul H. Edelstein
Affiliation:
Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Neil O. Fishman
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Knashawn H. Morales
Affiliation:
Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Department of Biostatistics and Epidemiology, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Andrew J. Baltus
Affiliation:
Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Ebbing Lautenbach
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Department of Biostatistics and Epidemiology, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
*
St. Luke's Hospital and Health Network, 801 Ostrum Street, Bethlehem, PA 18015 (mascitk@slhn.org)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective.

Staphylococcus aureus is a cause of community- and healthcare-acquired infections and is associated with substantial morbidity, mortality, and costs. Vancomycin minimum inhibitory concentrations (MICs) among S. aureus have increased, and reduced vancomycin susceptibility (RVS) may be associated with treatment failure. We aimed to identify clinical risk factors for RVS in S. aureus bacteremia.

Design.

Case-control.

Setting.

Academic tertiary care medical center and affiliated urban community hospital.

Patients.

Cases were patients with RVS S. aureus isolates (defined as vancomycin E-test MIC >1.0 μg/mL). Controls were patients with non-RVS S. aureus isolates.

Results.

Of 392 subjects, 134 (34.2%) had RVS. Fifty-eight of 202 patients (28.7%) with methicillin-susceptible S. aureus (MSSA) isolates had RVS, and 76 of 190 patients (40.0%) with methicillin-resistant S. aureus (MRSA) isolates had RVS (P = .02). In unadjusted analyses, prior vancomycin use was associated with RVS (odds ratio [OR], 2.08; 95% confidence interval [CI], 1.00–4.32; P = .046). In stratified analyses, there was significant effect modification by methicillin susceptibility on the association between vancomycin use and RVS (P = .04). In multivariate analyses, after hospital of admission and prior levofloxacin use were controlled for, the association between vancomycin use and RVS was significant for patients with MSSA infection (adjusted OR, 4.02; 95% CI, 1.11–14.50) but not MRSA infection (adjusted OR, 0.87; 95% CI, 0.36–2.13).

Conclusions.

A substantial proportion of patients with S. aureus bacteremia had RVS. The association between prior vancomycin use and RVS was significant for patients with MSSA infection but not MRSA infection, suggesting a complex relationship between the clinical and molecular epidemiology of RVS in S. aureus.

Infect Control Hosp Epidemiol 2012;33(2):160-166

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 2 , February 2012 , pp. 160 - 166
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Cosgrove, SE, Qi, Y, Kaye, KS, Harbarth, S, Karchmer, AW, Carmeli, Y. The impact of methicillin resistance in Staphylococcus aureus bacteremia on patient outcomes: mortality, length of stay, and hospital charges. Infect Control Hosp Epidemiol 2005;26(2):166–174.CrossRefGoogle ScholarPubMed
2.McDonald, LC. Trends in antimicrobial resistance in health care-associated pathogens and effect on treatment. Clin Infect Dis 2006;42(suppl 2):S65–S71.CrossRefGoogle ScholarPubMed
3.Kollef, MH. Limitations of vancomycin in the management of resistant staphylococcal infections. Clin Infect Dis 2007;45(suppl 3):S191–S195.CrossRefGoogle ScholarPubMed
4.Steinkraus, G, White, R, Friedrich, L. Vancomycin MIC creep in non-vancomycin-intermediate Staphylococcus aureus (VISA), vancomycin-susceptible clinical methicillin-resistant S. aureus (MRSA) blood isolates from 2001–05. J Antimicrob Chemother 2007;60(4):788–794.CrossRefGoogle ScholarPubMed
5.Wang, G, Hindler, JF, Ward, KW, Bruckner, DA. Increased vancomycin MICs for Staphylococcus aureus clinical isolates from a university hospital during a 5-year period. J Clin Microbiol 2006;44(11):3883–3886.CrossRefGoogle ScholarPubMed
6.Hidayat, LK, Hsu, DI, Quist, R, Shriner, KA, Wong-Beringer, A. High-dose vancomycin therapy for methicillin-resistant Staphylococcus aureus infections: efficacy and toxicity. Arch Intern Med 2006;166(19):2138–2144.CrossRefGoogle ScholarPubMed
7.Lodise, TP, Graves, J, Evans, A, et al. Relationship between vancomycin MIC and failure among patients with methicillin-resistant Staphylococcus aureus bacteremia treated with vancomycin. Antimicrob Agents Chemother 2008;52(9):3315–3320.CrossRefGoogle ScholarPubMed
8.Moise-Broder, PA, Sakoulas, G, Eliopoulos, GM, Schentag, JJ, Forrest, A, Moellering, RC Jr. Accessory gene regulator group II polymorphism in methicillin-resistant Staphylococcus aureus is predictive of failure of vancomycin therapy. Clin Infect Dis 2004;38(12):1700–1705.CrossRefGoogle ScholarPubMed
9.Sakoulas, G, Moise-Broder, PA, Schentag, J, Forrest, A, Moellering, RC Jr, Eliopoulos, GM. Relationship of MIC and bactericidal activity to efficacy of vancomycin for treatment of methicillin-resistant Staphylococcus aureus bacteremia. J Clin Microbiol 2004;42(6):2398–2402.CrossRefGoogle ScholarPubMed
10.Soriano, A, Marco, F, Martinez, JA, et al. Influence of vancomycin minimum inhibitory concentration on the treatment of methicillin-resistant Staphylococcus aureus bacteremia. Clin Infect Dis 2008;46(2):193–200.CrossRefGoogle ScholarPubMed
11.Wang, J-L, Wang, J-T, Sheng, W-H, Chen, Y-C, Chang, S-C. Nosocomial methicillin-resistant Staphylococcus aureus (MRSA) bacteremia in Taiwan: mortality analyses and the impact of vancomycin, MIC = 2 mg/L, by the broth microdilution method. BMC Infect Dis 2010;10(1):159.CrossRefGoogle ScholarPubMed
12.Moise, PA, Sakoulas, G, Forrest, A, Schentag, JJ. Vancomycin in vitro bactericidal activity and its relationship to efficacy in clearance of methicillin-resistant Staphylococcus aureus bacteremia. Antimicrob Agents Chemother 2007;51(7):2582–2586.CrossRefGoogle ScholarPubMed
13.Moise, PA, North, D, Steenbergen, JN, Sakoulas, G. Susceptibility relationship between vancomycin and daptomycin in Staphylococcus aureus: facts and assumptions. Lancet Infect Dis 2009;9(10):617–624.CrossRefGoogle ScholarPubMed
14.Patel, JB, Jevitt, LA, Hageman, J, McDonald, LC, Tenover, FC. An association between reduced susceptibility to daptomycin and reduced susceptibility to vancomycin in Staphylococcus aureus. Clin Infect Dis 2006;42(11):1652–1653.CrossRefGoogle ScholarPubMed
15.Lodise, TP, Miller, CD, Graves, J, et al. Predictors of high vancomycin MIC values among patients with methicillin-resistant Staphylococcus aureus bacteraemia. J Antimicrob Chemother 2008;62(5):1138–1141.CrossRefGoogle ScholarPubMed
16.Moise, PA, Smyth, DS, El-Fawal, N, et al. Microbiological effects of prior vancomycin use in patients with methicillin-resistant Staphylococcus aureus bacteraemia. J Antimicrob Chemother 2007;61(1):85–90.CrossRefGoogle ScholarPubMed
17.Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing—Eighteenth Informational Supplement. Wayne, PA: CLSI; 2008. CLSI document M100-S18.Google Scholar
18.CLSI. Performance Standards for Antimicrobial Disk Susceptibility Tests: Approved Standard—Ninth Edition. Wayne, PA: CLSI; 2006. CLSI document M2-A9.Google Scholar
19.CLSI. Methods for Dilutional Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically: Approved Standard—Seventh Edition. Wayne, PA: CLSI; 2006. CLSI document M7-A7.Google Scholar
20.Bannerman, TL, Peacock, SJ. Staphylococcus, micrococcus, and other catalase-positive cocci. In: Murray, PR, Baron, EJ, Jorgensen, JH, Landry, ML, Pfaller, MA, eds. Manual of Clinical Microbiology. Washington, DC: ASM; 2007:390–411.Google Scholar
21.Biodisk, A. E-test Technical Manual. http://www.abbiodisk.com/bd_litt_etm.html. Accessed February 18, 2011.Google Scholar
22.Satola, SW, Farley, MM, Anderson, KF, Patel, JB. Comparison of detection methods for heteroresistant vancomycin-intermediate Staphylococcus aureus, with the population analysis profile method as the reference method. J Clin Microbiol 2011;49(1):177–183.CrossRefGoogle ScholarPubMed
23.Fitzgibbon, MM, Rossney, AS, O'Connell, B. Investigation of reduced susceptibility to glycopeptides among methicillin-resistant Staphylococcus aureus isolates from patients in Ireland and evaluation of agar screening methods for detection of heterogeneously glycopeptide-intermediate S. aureus. J Clin Microbiol 2007;45(10):3263–3269.CrossRefGoogle ScholarPubMed
24.Wootton, M, MacGowan, AP, Walsh, TR, Howe, RA. A multicenter study evaluating the current strategies for isolating Staphylococcus aureus strains with reduced susceptibility to glycopeptides. J Clin Microbiol 2006;45(2):329–332.CrossRefGoogle ScholarPubMed
25.Liu, C, Bayer, A, Cosgrove, SE, et al. Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children. Clin Infect Dis 2011;52(3):e18–e55.CrossRefGoogle Scholar
26.Gasink, LB, Fishman, NO, Weiner, MG, Nachamkin, I, Bilker, WB, Lautenbach, E. Fluoroquinolone-resistant Pseudomonas aeruginosa: assessment of risk factors and clinical impact. Am J Med 2006;119(6):e519–e525.CrossRefGoogle ScholarPubMed
27.Quain, RD, Barton, TD, Fishman, NO, Weiner, MG, Lautenbach, E. Coadministration of oral levofloxacin with agents that impair its absorption: potential impact on emergence of resistance. Int J Antimicrob Agents 2005;26(4):327–330.CrossRefGoogle ScholarPubMed
28.Quan, H, Sundararajan, V, Halfon, P, et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 2005;43(11):1130–1139.CrossRefGoogle ScholarPubMed
29.MacAdam, H, Zaoutis, TE, Gasink, LB, Bilker, WB, Lautenbach, E. Investigating the association between antibiotic use and antibiotic resistance: impact of different methods of categorising prior antibiotic use. Int J Antimicrob Agents 2006;28(4):325–332.CrossRefGoogle ScholarPubMed
30.Kleinbaum, DG, Kupper, LL, Morgenstern, H. Epidemiologic Research: Principles and Quantitative Methods. New York: Van Nostrand Reinhold; 1982.Google Scholar
31.Mantel, N, Haenszel, W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst 1959;22(4):719–748.Google ScholarPubMed
32.Hosmer, DO, Lemeshow, SL. Applied Logistic Regression. New York: Wiley; 1989.Google Scholar
33.Sun, GW, Shook, TL, Kay, GL. Inappropriate use of bivariable analysis to screen risk factors for use in multivariable analysis. J Clin Epidemiol 1996;49(8):907–916.CrossRefGoogle ScholarPubMed
34.Mickey, RM, Greenland, S. The impact of confounder selection criteria on effect estimation. Am J Epidemiol 1989;129(1):125–137.CrossRefGoogle ScholarPubMed
35.Ender, M, McCallum, N, Adhikari, R, Berger-Bachi, B. Fitness cost of SCCmec and methicillin resistance levels in Staphylococcus aureus. Antimicrob Agents Chemother 2004;48(6):2295–2297.CrossRefGoogle ScholarPubMed
36.Bloemendaal, AL, Fluit, AC, Jansen, WT, et al. Colonization with multiple Staphylococcus aureus strains among patients in European intensive care units. Infect Control Hosp Epidemiol 2009;30(9):918–920.CrossRefGoogle ScholarPubMed
37.Mongkolrattanothai, K, Gray, BM, Mankin, P, et al. Simultaneous carriage of multiple genotypes of Staphylococcus aureus in children. J Med Microbiol 2010;60(3):317–322.CrossRefGoogle ScholarPubMed
38.Noto, MJ, Fox, PM, Archer, GL. Spontaneous deletion of the methicillin resistance determinant, mecA, partially compensates for the fitness cost associated with high-level vancomycin resistance in Staphylococcus aureus. Antimicrob Agents Chemother 2008;52(4):1221–1229.CrossRefGoogle ScholarPubMed
39.Weber, SG, Gold, HS, Hooper, DC, Karchmer, AW, Carmeli, Y. Fluoroquinolones and the risk for methicillin-resistant Staphylococcus aureus in hospitalized patients. Emerg Infect Dis 2003;9(11):1415–1422.CrossRefGoogle ScholarPubMed
40.Sader, HS, Fritsche, TR, Jones, RN. Daptomycin bactericidal activity and correlation between disk and broth microdilution method results in testing of Staphylococcus aureus strains with decreased susceptibility to vancomycin. Antimicrob Agents Chemother 2006;50(7):2330–2336.CrossRefGoogle ScholarPubMed
41.Keel, RA, Sutherland, CA, Aslanzadeh, J, Nicolau, DP, Kuti, JL. Correlation between vancomycin and daptomycin MIC values for methicillin-susceptible and methicillin-resistant Staphylococcus aureus by 3 testing methodologies. Diagn Microbiol Infect Dis 2010;68(3):326–329.CrossRefGoogle ScholarPubMed