title: Clinical features associated with bacteremia due to heterogeneous vancomycin-intermediate Staphylococcus aureus.
abstract: We assessed all episodes of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia at our hospital during a 12-month period (n=53) and compared those due to heterogeneous vancomycin-intermediate S. aureus (hVISA; n = 5, 9.4%) with those due to vancomycin-susceptible MRSA (n=48). Patients with hVISA bacteremia were more likely to have high bacterial load infections (P=.001), vancomycin treatment failure (persistent fever and bacteremia for >7 days after the start of therapy; P<.001), and initially low serum vancomycin levels (P=.006). These clinical markers of hVISA bacteremia may help focus diagnostic efforts and treatment.
authors.affiliation: Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia. patrick.charles@mh.org.au
authors.forename: Patrick G P
authors.initials: PG
authors.lastname: Charles
authors.forename: Peter B
authors.initials: PB
authors.lastname: Ward
authors.forename: Paul D R
authors.initials: PD
authors.lastname: Johnson
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Howden
authors.forename: M Lindsay
authors.initials: ML
authors.lastname: Grayson
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D006801:Humans; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects*; D014640:Vancomycin / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin