title: Antibiotic susceptibility survey of blood-borne MRSA isolates in Japan from 2008 through 2011.
abstract: We conducted an antibiotic susceptibility survey of 830 blood-borne methicillin resistant Staphylococcus aureus collected from nationwide hospitals in Japan over a three-year period from January 2008 through May 2011. Antibiotic susceptibility was judged according to the criteria recommended by the Clinical Laboratory Standard Institute. Over 99% of the MRSA showed to be susceptible to teicoplanin, linezolid, sulfamethoxazole/trimethoprim and vancomycin, and over 97% of them were susceptible to daptomycin, arbekacin and rifampin. The majority of the MRSA strains showed resistant to minocycline, meropenem, imipenem, clindamycin, ciprofloxacin, cefoxitin, and oxacillin in the rates of 56.6, 72.9, 73.7, 78.7, 89.0, 99.5, and 99.9%, respectively. Among the MRSA strains, 72 showed reduced susceptibility to vancomycin, including 8 strains (0.96%) of vancomycin-intermediate S. aureus (VISA), 54 (6.51%) of heterogeneous vancomycin-intermediate S. aureus (hVISA), and 55 (5.63%) of β-lactam antibiotics-induced vancomycin resistant S. aureus (BIVR). Unexpectedly, among the 54 hVISA and 55 BIVR, 45 isolates (83.3% and 81.8%, respectively) showed both hVISA and BIVR phenotypes. A new trend of vancomycin resistance found in this study was that VISA strains were still prevalent among the bacteremic specimens. The high rates of the hVISA/BIVR two-phenotypic vancomycin resistance, and the prevalence of VISA in the bloodborne MRSA call attention in the MRSA epidemiology in Japan.
authors: Research Center for Infections and Antimicrobials, Kitasato Institute for Life Science, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-864, Japan. Electronic address: hanaki@insti.kitasato-u.ac.jp.
authors: Hideaki
authors: H
authors: Hanaki
authors: Research Center for Infections and Antimicrobials, Kitasato Institute for Life Science, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-864, Japan.
authors: Longzhu
authors: L
authors: Cui
authors: Research Center for Infections and Antimicrobials, Kitasato Institute for Life Science, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-864, Japan.
authors: Yurika
authors: Y
authors: Ikeda-Dantsuji
authors: Research Center for Infections and Antimicrobials, Kitasato Institute for Life Science, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-864, Japan.
authors: Taiji
authors: T
authors: Nakae
authors: Department of Infection Control, St Mary's Hospital, Fukuoka, Japan.
authors: Junichi
authors: J
authors: Honda
authors: Department of Laboratory Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
authors: Katsunori
authors: K
authors: Yanagihara
authors: Department of Infection Control and Prevention, Hyogo College of Medicine, Hyogo, Japan.
authors: Yoshio
authors: Y
authors: Takesue
authors: Department of Microbiology, Tokyo Medical University, Tokyo, Japan.
authors: Tetsuya
authors: T
authors: Matsumoto
authors: Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan.
authors: Keisuke
authors: K
authors: Sunakawa
authors: Central Clinical Laboratory, Department of Infection Control and Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan.
authors: Mitsuo
authors: M
authors: Kaku
authors: Department of Clinical Infectious Disease, Osaka University School of Medicine, Osaka, Japan.
authors: Kazunori
authors: K
authors: Tomono
authors: Department of Laboratory Medicine, Showa University School of Medicine, Tokyo, Japan.
authors: Kunihiko
authors: K
authors: Fukuchi
authors: Faculty of Medicine, School of Medicine, 3rd Dept. of Surg. Toho Univ. School of Med., Japan.
authors: Shinya
authors: S
authors: Kusachi
authors: Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan.
authors: Hiroshige
authors: H
authors: Mikamo
authors: Department of Infection Control, Fukuoka University Hospital, Fukuoka, Japan.
authors: Tohru
authors: T
authors: Takata
authors: Department of Laboratory Medicine, Kameda Medical Center, Chiba, Japan.
authors: Yoshihito
authors: Y
authors: Otsuka
authors: Department of Laboratory Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.
authors: Osanori
authors: O
authors: Nagura
authors: St. Marianna University, Kanagawa, Japan.
authors: Shigeki
authors: S
authors: Fujitani
authors: Department of International Medicine, Division of Infectious Diseases, Faculty of Medicine, Saga University, Japan.
authors: Yosuke
authors: Y
authors: Aoki
authors: Department of Clinical Research, National Hospital Organization, Tochigi Medical Center, Tochigi, Japan.
authors: Yoshio
authors: Y
authors: Yamaguchi
authors: Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo 143-8540, Japan.
authors: Kazuhiro
authors: K
authors: Tateda
authors: Internal Medicine 2, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu 879-5593, Japan.
authors: Junichi
authors: J
authors: Kadota
authors: Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
authors: Shigeru
authors: S
authors: Kohno
authors: Department of Clinical Infectious Diseases, Showa University School of Medicine, Tokyo, Japan.
authors: Yoshihito
authors: Y
authors: Niki
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D006801:Humans; D007564:Japan; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests / Q000379:methods; D013203:Staphylococcal Infections / Q000097:blood / Q000188:drug therapy / Q000382:microbiology*; D020713:Vancomycin Resistance / Q000502:physiology; D047090:beta-Lactams / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams
keywords: Antibiotic susceptibility surveillance; Blood-borne MRSA; Heterogeneous VISA (hetero-VISA or hVISA); MRSA; Vancomycin-intermediate Staphylococcus aureus (VISA); β-lactam antibiotics-induced vancomycin resistant S. aureus (BIVR)