title: Prevalence, molecular epidemiology, and clinical significance of heterogeneous glycopeptide-intermediate Staphylococcus aureus in liver transplant recipients.
abstract: We investigated the prevalence, molecular epidemiology, and clinical significance of heterogeneous glycopeptide-intermediate Staphylococcus aureus (hGISA) isolates in 48 liver transplant recipients infected or colonized with methicillin-resistant S. aureus over a 5-year period. Strains were screened for hGISA on Mueller-Hinton agar containing 5 mg of teicoplanin per liter. Heterogeneous glycopeptide resistance was confirmed by the E-test method with a dense inoculum and a simplified method of population analysis. hGISA strains were found in 13 (27%) of the 48 patients studied. Eleven of the 13 strains shared a common multiresistant phenotype with homogeneous methicillin resistance and gentamicin resistance, and they were closely related according to the results of pulsed-field gel electrophoresis. Only 2 of the 13 patients infected or colonized with hGISA strains had previously received glycopeptide therapy. Most patients were successfully treated with vancomycin, but one patient who failed to respond to vancomycin subsequently died. These results suggest that the high prevalence of hGISA among our patients was due to the clonal spread of a multiresistant strain.
authors: Department of Microbiology, Hospital Beaujon, Clichy, France. bertfrederic@hotmail.com
authors: Frédéric
authors: F
authors: Bert
authors: Juliette
authors: J
authors: Clarissou
authors: François
authors: F
authors: Durand
authors: Didier
authors: D
authors: Delefosse
authors: Chantal
authors: C
authors: Chauvet
authors: Patricia
authors: P
authors: Lefebvre
authors: Nicole
authors: N
authors: Lambert
authors: Catherine
authors: C
authors: Branger
mesh_terms: D005602:France / Q000453:epidemiology; D006020:Glycopeptides / Q000032:analysis*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D010802:Phylogeny; D011183:Postoperative Complications / Q000453:epidemiology / Q000382:microbiology*; D015995:Prevalence; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D006020:Glycopeptides