Increased Vancomycin MICs for
            <i>Staphylococcus aureus</i>
            Clinical Isolates from a University Hospital during a 5-Year Period

Wang, Guiqing; Hindler, Janet F.; Ward, Kevin W.; Bruckner, David A.

doi:10.1128/jcm.01388-06

Cited by 340 publications

(209 citation statements)

References 29 publications

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“…To achieve this target for S. aureus strains with MICs of 1 mg/L, a continuous serum concentration of 20 mg/L is needed [11]. However, as a tendency towards increasing vancomycin MICs (≥1 mg/L) in S. aureus clinical isolates is already being reported, a plateau concentration of vancomycin of 25 mg/L seems more appropriate [12]. Moreover, the pharmacokinetics of vancomycin can be significantly altered in critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

A higher dose of vancomycin in continuous infusion is needed in critically ill patients

Jeurissen¹,

Sluyts

Rutsaert³

2011

International Journal of Antimicrobial Agents

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International audienceCompared with intermittent infusion, continuous infusion of vancomycin is cheaper and logistically more convenient, achieves target concentrations faster, results in less variability in serum vancomycin concentrations, requires less therapeutic drug monitoring and causes less nephrotoxicity. Given that critically ill patients may develop very large volumes of distribution as well as supranormal drug clearance, in this study it was shown, despite the limited number of patients studied, that to achieve a target plateau concentration of 25mg/L a daily dose of 3000mg of vancomycin in continuous infusion is needed following an appropriate loading dose

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Section: Discussionmentioning

confidence: 99%

A higher dose of vancomycin in continuous infusion is needed in critically ill patients

Jeurissen¹,

Sluyts

Rutsaert³

2011

International Journal of Antimicrobial Agents

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“…Although the prevalence of S. aureus strains with reduced vancomycin susceptibility remains low, such strains have been associated with vancomycin treatment failure, limiting the treatment options for patients with such infections and necessitating that clinicians consider the use of other antimicrobials [2]. Many health care facilities have reported an increasing prevalence of MRSA strains with vancomycin MICs of 2 µg/ml, which is at the upper limit of the Clinical and Laboratory Standards Institute (CLSI) susceptibility range [3,4], and some have detected an association of these isolates with prolonged bacteremia, greater rates of complications, and vancomycin therapeutic failures [5]. In addition, MRSA with vancomycin MICs of 2 µg/ml are more likely than MRSA with vancomycin MICs of ≤1 µg/ml, to represent a heterogeneous population that may include subpopulations with intermediate resistance to vancomycin [6].…”

Section: Introductionmentioning

confidence: 99%

Vancomycin susceptibility trends of methicillin-resistant Staphylococcus aureus isolated from burn wounds: a time for action

Zorgani

Elahmer

Abaid³

et al. 2015

J Infect Dev Ctries

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Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) with reduced susceptibility to vancomycin poses a threat for patients in burn units throughout the world. This study aimed to investigate the reduced susceptibility to vancomycin of MRSA isolated from wounds of patients admitted to the Burns and Plastic Surgery Centre in Tripoli, Libya. Methodology: All isolates were initially identified by chromagen medium then confirmed by PCR. The minimum inhibition concentration (MIC) was determined by E-test glycopeptide resistance detection (GRD). Results: During the study, 210 isolates were obtained from 560 patients representing 132 (62.9%) and 78 (37.1%) of total samples received during years 2009 and 2010, respectively. MIC levels for vancomycin ranged from 0.5 to 2 µg/ml during the study, 13% of isolates displayed MIC of 1.5 µg/ml and 9% of the isolates displayed 2 µg/ml. Although MRSA isolates decreased dramatically during 2010 (37.1%) compared to 2009 (62.9%), overall, there was a significant increase in the proportion of MRSA isolates exhibiting higher vancomycin MICs during 2010 compared to 2009 (P = 0.0155). There was a significant increase of MICs at 1 µg/ml during 2010 compared with 2009 (P = 0.36). No vancomycin intermediate or resistant strains were found. Conclusion: There was a significant increase in the proportion of MRSA isolates exhibiting higher vancomycin MICs. We recommend that MRSA isolates should be monitored. Furthermore, implementation of infection control measures is urgently needed to prevent the spread of MRSA.

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“…These recommendations have been supported by the results of recent studies showing that minimal inhibitory concentration (MIC) of VAN against SA has increased since the 90s. There are studies reporting an incidence of strains with MIC > 1 µg/ml higher than 50%, which is associated to a decreased therapeutic effectiveness (21)(22)(23)(24). In this setting, if VAN administration is decided, MICs of VAN against the pathogens involved would have to be known and VAN plasma levels would have to be monitored, mainly in critically ill patients with severe sepsis, in whom changes in hemodynamics and distribution volume are also common.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to tolerability and renal toxicity problems, a high treatment failure rate in severe infections has been reported for VAN, probably related to its poor tissue penetration in the lung, bone tissue, central nervous system (CNS), and inflammatory fluids (16)(17)(18)(19)(20). This requires use of higher doses, with the resultant increase in adverse events, one of the most significant of which is renal function impairment (21)(22)(23)(24)(25)(26). Despite these limitations, this glycopeptide continues to be widely used at Spanish ICUs.…”

Section: Introductionmentioning

confidence: 99%

Impact of administration of vancomycin or linezolid to critically ill patients with impaired renal function

Colomo

Lerma

Perez

et al. 2011

Eur J Clin Microbiol Infect Dis

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Objective: To assess the impact on renal function of vancomycin (VAN) versus linezolid (LZD) in patients with renal failure (RF) admitted to intensive care units. Materials and methods:Multicenter, retrospective, comparative cohort study. Renal failure's patients were treated with VAN or LZD for proven or suspected infections by multiresistant Gram-positive cocci. Changes in plasma creatinine levels and creatinine clearance at the start and end of treatment were used as endpoints.Results: 147 patients treated with VAN (Group A = 68) In Group A, 9 patients (13.2%) experienced an antibiotic-related increase in RF, and antibiotic was discontinued in five patients due to adverse effects. Conclusion:It is reasonable to avoid use of VAN in critically ill patients with acute renal failure.

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Increased Vancomycin MICs for Staphylococcus aureus Clinical Isolates from a University Hospital during a 5-Year Period

Cited by 340 publications

References 29 publications

A higher dose of vancomycin in continuous infusion is needed in critically ill patients

A higher dose of vancomycin in continuous infusion is needed in critically ill patients

Vancomycin susceptibility trends of methicillin-resistant Staphylococcus aureus isolated from burn wounds: a time for action

Impact of administration of vancomycin or linezolid to critically ill patients with impaired renal function

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