Impact of Vancomycin Minimum Inhibitory Concentration on Mortality among Critically Ill Patients witn Methicillin-Resistant <i>Staphylococcus aureus</i> Bacteremia

Woods, Christian; Chowdhury, Anindita; Patel, Vinay; Shorr, Andrew F.

doi:10.1086/668433

Cited by 13 publications

(3 citation statements)

References 11 publications

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“…After reviewing the full texts, we excluded other studies according to the eligibility criteria. Twenty studies (4,5,(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) were included in the final analysis. The process of article selection is shown in Figure 1.…”

Section: Results Of Study Inclusionmentioning

confidence: 99%

Predictors of mortality in adult patients with methicillin-resistant Staphylococcus aureus bloodstream infection: a meta-analysis and systematic review

Ju¹,

Huang²,

Xu³

et al. 2021

Ann Palliat Med

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Background: Cases of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection have been increasing. Patients with MRSA bloodstream infection have a poor prognosis and high mortality rate. Identification of potential risk factors associated with MRSA bloodstream infection-related mortality may help improve patient outcomes. Methods: Embase, PubMed, and the Cochrane Library databases were searched to identify articles describing predictors of mortality in patients with MRSA bloodstream infections. Two investigators independently assessed articles for inclusion and data extraction.Results: Twenty observational studies were included in the analysis. Factors associated with higher mortality were development of severe sepsis or septic shock [

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Section: Results Of Study Inclusionmentioning

confidence: 99%

Predictors of mortality in adult patients with methicillin-resistant Staphylococcus aureus bloodstream infection: a meta-analysis and systematic review

Ju¹,

Huang²,

Xu³

et al. 2021

Ann Palliat Med

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“…The failure of vancomycin treatment in certain S. aureus infections which, based on standard susceptibility testing, should have been susceptible to the bactericidal effects of this antimicrobial (i.e., VSSA strains) has been well documented ( 31 – 40 ). MIC elevations comparable to those induced by colistin exposure have been associated with increased mortality ( 32 , 35 , 37 , 41 ). As removal of colistin restored vancomycin sensitivity to the precolistin level, our results raise the prospect that an infecting S. aureus strain isolated from a patient receiving colistin may be reported as being highly sensitive ( 42 ), whereas the actual susceptibility of bacteria present in that patient may be reduced.…”

Section: Discussionmentioning

confidence: 99%

Reversible Antibiotic Tolerance Induced in Staphylococcus aureus by Concurrent Drug Exposure

Haaber

Friberg

McCreary

et al. 2015

mBio

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Resistance of Staphylococcus aureus to beta-lactam antibiotics has led to increasing use of the glycopeptide antibiotic vancomycin as a life-saving treatment for major S. aureus infections. Coinfection by an unrelated bacterial species may necessitate concurrent treatment with a second antibiotic that targets the coinfecting pathogen. While investigating factors that affect bacterial antibiotic sensitivity, we discovered that susceptibility of S. aureus to vancomycin is reduced by concurrent exposure to colistin, a cationic peptide antimicrobial employed to treat infections by Gram-negative pathogens. We show that colistin-induced vancomycin tolerance persists only as long as the inducer is present and is accompanied by gene expression changes similar to those resulting from mutations that produce stably inherited reduction of vancomycin sensitivity (vancomycin-intermediate S. aureus [VISA] strains). As colistin-induced vancomycin tolerance is reversible, it may not be detected by routine sensitivity testing and may be responsible for treatment failure at vancomycin doses expected to be clinically effective based on such routine testing.Importance Commonly, antibiotic resistance is associated with permanent genetic changes, such as point mutations or acquisition of resistance genes. We show that phenotypic resistance can arise where changes in gene expression result in tolerance to an antibiotic without any accompanying genetic changes. Specifically, methicillin-resistant Staphylococcus aureus (MRSA) behaves like vancomycin-intermediate S. aureus (VISA) upon exposure to colistin, which is currently used against infections by Gram-negative bacteria. Vancomycin is a last-resort drug for treatment of serious S. aureus infections, and VISA is associated with poor clinical prognosis. Phenotypic and reversible resistance will not be revealed by standard susceptibility testing and may underlie treatment failure.

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“…With increased use, the susceptibility of MRSA to vancomycin has been shifting toward higher MICs, termed MIC creep, which has been associated with increased mortality. Woods and colleagues 43 reported that the prevalence of MRSA with an MIC of 2 mg/L in their patients in ICUs with bacteremia was 5.1%. They noted an escalation of mortality as MIC increased, up to 80% when reaching an MIC of 2 mg/L.…”

Section: Gram-positive Infectionsmentioning

confidence: 99%

Management of Infections with Drug-Resistant Organisms in Critical Care

Trevino

Kollef

2015

Clinics in Chest Medicine

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Impact of Vancomycin Minimum Inhibitory Concentration on Mortality among Critically Ill Patients witn Methicillin-Resistant Staphylococcus aureus Bacteremia

Cited by 13 publications

References 11 publications

Predictors of mortality in adult patients with methicillin-resistant Staphylococcus aureus bloodstream infection: a meta-analysis and systematic review

Predictors of mortality in adult patients with methicillin-resistant Staphylococcus aureus bloodstream infection: a meta-analysis and systematic review

Reversible Antibiotic Tolerance Induced in Staphylococcus aureus by Concurrent Drug Exposure

Management of Infections with Drug-Resistant Organisms in Critical Care

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