title: In vitro selection of resistance to vancomycin in bloodstream isolates of Staphylococcus haemolyticus and Staphylococcus epidermidis.
abstract: The purpose of the study was to determine whether vancomycin-resistant strains of Staphylococcus haemolyticus could be selected regardless of the initial MIC of vancomycin. Twenty-one bloodstream isolates of Staphylococcus haemolyticus were studied by broth and agar selection methods. The broth method selected strains for which MICs of vancomycin ranged from 4 to 32 micrograms/ml and MBCs from 16 to greater than 128 micrograms/ml. The agar method selected strains for which MICs ranged from 8 to 32 micrograms/ml and MBCs from 8 to greater than 128 micrograms/ml. For comparison, seven strains of Staphylococcus epidermidis were evaluated by the agar selection method. Final MICs of vancomycin ranged from 8 to 16 micrograms/ml; MBCs ranged from 16 to 64 micrograms/ml. Clearly, in vitro exposure to vancomycin can select strains of Staphylococcus haemolyticus and Staphylococcus epidermidis for which MIC values are beyond the susceptible breakpoint.
authors.affiliation: Department of Internal Medicine, University of Iowa College of Medicine, Iowa City.
authors.forename: L
authors.initials: L
authors.lastname: Herwaldt
authors.forename: L
authors.initials: L
authors.lastname: Boyken
authors.forename: M
authors.initials: M
authors.lastname: Pfaller
mesh_terms: D016470:Bacteremia / Q000382:microbiology; D003470:Culture Media; D004352:Drug Resistance, Microbial; D006801:Humans; D008826:Microbial Sensitivity Tests; D013203:Staphylococcal Infections / Q000382:microbiology; D013210:Staphylococcus / Q000187:drug effects* / Q000302:isolation & purification; D013212:Staphylococcus epidermidis / Q000187:drug effects / Q000302:isolation & purification; D014640:Vancomycin / Q000494:pharmacology*
chemical_list: D003470:Culture Media; D014640:Vancomycin