TY - JOUR
T1 - Bacteremia due to Staphylococcus aureus with reduced susceptibility to vancomycin
AU - Wong, Samson Sai Yin
AU - Ng, Tak Keung
AU - Yam, Wing Cheong
AU - Tsang, Dominic Ngai Chong
AU - Woo, Patrick Chiu Yat
AU - Fung, Samuel Ka Shun
AU - Yuen, Kwok Yung
PY - 2000/4
Y1 - 2000/4
N2 - Four cases of bacteremia caused by Staphylococcus aureus with heteroresistance to vancomycin (hetero-VRSA) were described. In at least two of these four mortalities, the cause of death was temporally related to the hetero-VRSA bacteremia. The vancomycin and teicoplanin MICs of the resistant subpopulations of these four hetero-VRSA were 8 and 24 μg/ml, respectively. All isolates were producers of β-lactamase, produced penicillin-binding protein PBP2a, and possessed the mecA gene accounting for methicillin resistance. Thickening of the peptidoglycan cell wall was observed by electron microscopy. When ampicillin was combined with vancomycin, in vitro synergism was detected using the checkerboard titration method (εFIC = 0.13). The use of vancomycin plus ampicillin-sulbactam could be a viable option in treating severe hetero-VRSA infection in view of the higher affinity of ampicillin toward PBP2a. Copyright (C) 2000 Elsevier Science Inc.
AB - Four cases of bacteremia caused by Staphylococcus aureus with heteroresistance to vancomycin (hetero-VRSA) were described. In at least two of these four mortalities, the cause of death was temporally related to the hetero-VRSA bacteremia. The vancomycin and teicoplanin MICs of the resistant subpopulations of these four hetero-VRSA were 8 and 24 μg/ml, respectively. All isolates were producers of β-lactamase, produced penicillin-binding protein PBP2a, and possessed the mecA gene accounting for methicillin resistance. Thickening of the peptidoglycan cell wall was observed by electron microscopy. When ampicillin was combined with vancomycin, in vitro synergism was detected using the checkerboard titration method (εFIC = 0.13). The use of vancomycin plus ampicillin-sulbactam could be a viable option in treating severe hetero-VRSA infection in view of the higher affinity of ampicillin toward PBP2a. Copyright (C) 2000 Elsevier Science Inc.
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U2 - 10.1016/S0732-8893(99)00141-8
DO - 10.1016/S0732-8893(99)00141-8
M3 - Article
C2 - 10764969
AN - SCOPUS:0034074492
SN - 0732-8893
VL - 36
SP - 261
EP - 268
JO - Diagnostic Microbiology and Infectious Disease
JF - Diagnostic Microbiology and Infectious Disease
IS - 4
ER -