[Clinical microbiological investigation of vancomycin intermediate Staphylococcus aureus during glycopeptide therapy].
We isolated three strains of vancomycin intermediate Staphylococcus aureus (VISA) from a blood sample of a patient with infective endocarditis (VISA-1), postoperative pneumonia sputum (VISA-2), and pyogenic spondylitis blood sample (VISA-3). These VISA strains did not carry vanA, vanB, vanC1, or vanC2/C3 genes. Cell wall thickening was observed. VISA-1 and VISA-3 PFGE patterns showed the completely same pattern compared to the PFGE pattern of methicillin-resistant Staphylococcus aureus first isolated from patients 1 and 3. After 10 days on brain heart infusion agar, wall thickening in all three type of VISA was unchanged, but VISA-2 and VISA-3 reversed vancomycin susceptibility. The most suitable use of vancomycin in patients with MRSA infection thus appears to be in reducing the opportunity for cell wall thickening.
Department of Clinical Laboratory, Kinki University Hospital.
Hirofumi
H
Toda
Toshihiro
T
Yamaguchi
Takayuki
T
Miyara
Akihiro
A
Hisato
Tomohide
T
Matsushima
Takahiro
T
Shimada
Hiroyuki
H
Sano
Kenichi
K
Nakae
Toshinori
T
Kamisako
D000368:Aged; D006020:Glycopeptides / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification / Q000648:ultrastructure; D008826:Microbial Sensitivity Tests; D017334:Teicoplanin / Q000627:therapeutic use; D014640:Vancomycin / Q000494:pharmacology* / Q000627:therapeutic use
D006020:Glycopeptides; D017334:Teicoplanin; D014640:Vancomycin