title: Vancomycin minimum inhibitory concentration, host comorbidities and mortality in Staphylococcus aureus bacteraemia.
abstract: We reported an association between elevated vancomycin MIC and 30-day mortality in patients with Staphylococcus aureus bacteraemia (SAB), including patients with methicillin-susceptible S. aureus (MSSA) treated with flucloxacillin. A detailed analysis of comorbidities and disease severity scores in the same cohort of patients was performed to ascertain if unknown clinical parameters may have influenced these results. The association between elevated vancomycin MIC and 30-day mortality in SAB remained significant (p 0.001) on multivariable logistic regression analysis even when accounting for clinical factors. In addition, the association persisted when restricting analysis to patients with MSSA bacteraemia treated with flucloxacillin. This suggests that elevated vancomycin MIC is associated with but not causally linked to an organism factor that is responsible for increased mortality.
authors: Austin Centre for Infection Research, Department of Infectious Diseases, Austin Health, Heidelberg, Vic., Australia; Department of Medicine, University of Melbourne, Parkville, Vic., Australia.
authors: N E
authors: NE
authors: Holmes
authors: J D
authors: JD
authors: Turnidge
authors: W J
authors: WJ
authors: Munckhof
authors: J O
authors: JO
authors: Robinson
authors: T M
authors: TM
authors: Korman
authors: M V N
authors: MV
authors: O'Sullivan
authors: T L
authors: TL
authors: Anderson
authors: S A
authors: SA
authors: Roberts
authors: S J C
authors: SJ
authors: Warren
authors: W
authors: W
authors: Gao
authors: P D R
authors: PD
authors: Johnson
authors: B P
authors: BP
authors: Howden
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality*; D013211:Staphylococcus aureus / Q000187:drug effects*; D016896:Treatment Outcome; D014640:Vancomycin / Q000494:pharmacology* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: Bacteraemia; Staphylococcus aureus; comorbidity; mortality; vancomycin minimum inhibitory concentration