title: High vancomycin minimum inhibitory concentration is associated with poor outcome in patients with methicillin-susceptible Staphylococcus aureus bacteremia regardless of treatment.
abstract: We retrospectively investigated the impact of high vancomycin minimum inhibitory concentration (MIC > 2 μg/ml) on the outcome of 53 patients with bacteremia caused by methicillin-susceptible Staphylococcus aureus (MSSA). Vancomycin MIC was determined by broth microdilution according to CLSI methods. The primary outcome was 30-day all-cause mortality from the date of the first positive blood culture. The mortality rate was 22.6% (12 of 53 patients). High vancomycin MIC (odds ratio (OR) = 9.3; 95% confidence interval (95% CI) = 1.31-63.20; p = 0.027), Charlson comorbidity index ≥ 3 (OR = 10.3; 95% CI = 1.3-102.04; p = 0.03), advanced age (OR = 35.8; 95% CI = 2.3-659.2; p = 0.01), and severe sepsis (OR = 8.5; 95% CI = 1.2-61.4; p = 0.03) were associated with mortality.
authors.affiliation: From the Unidad de Enfermedades Infecciosas, Hospital General Universitario de Ciudad Real, Universidad de Castilla La Mancha , Ciudad Real , Spain.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Castón
authors.forename: Francisco
authors.initials: F
authors.lastname: González-Gasca
authors.forename: Lourdes
authors.initials: L
authors.lastname: Porras
authors.forename: Soledad
authors.initials: S
authors.lastname: Illescas
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Romero
authors.forename: Julio
authors.initials: J
authors.lastname: Gijón
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; 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*; D015996:Survival Rate; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: Staphylococcus aureus; bacteremia; minimum inhibitory concentration; mortality; vancomycin