Published February 6, 2024
| Version v1
Publication
Is reduced vancomycin susceptibility a factor associated with poor prognosis in MSSA bacteraemia?
Description
Objectives: The known data about the influence of vancomycin MIC on Staphylococcus aureus bacteraemia are
contradictory. Our objective was to study the possible impact of vancomycin MIC ≥1.5 mg/L on short- and
medium-term mortality.
Methods: A prospective cohort study was carried out from March 2008 to January 2011 on adult patients with
MSSA bacteraemia admitted to a tertiary hospital located in Seville (Spain). We studied the relationship between
vancomycin MIC, accessory gene regulator (agr) type and absence of d-haemolysin and poor prognosis. All isolates were genotyped by PFGE. Multivariate analysis, including a propensity score for having a vancomycin MIC of
≥1.5 mg/L, was performed by Cox regression.
Results: One-hundred and thirty-five episodes of bacteraemia due to MSSAwere included in the analysis. Twentynine (21.5%) isolates had a vancomycin MIC of ≥1.5 mg/L by Etest. There were no differences in agr distribution or
absence of d-haemolysin between isolates with reduced vancomycin susceptibility (RVS) and those without. RVS
was not more frequent in specific clones; RVS was not associated with higher 14 or 30 day crude mortality
SQ1 (RR¼0.44, 95% CI¼0.14 –1.35; and RR¼1.01, 95% CI¼0.52 –1.96) rates, and it did not show higher rates of
complicated bacteraemia (14.2% versus 13.8%, P¼0.61). Cox regression analysis did not significantly modify
the results for 14 day mortality (HR¼0.39, 95% CI¼0.11 –1.34) or 30 day mortality (HR¼0.89, 95%
CI¼0.39 –2.04).
Conclusions: Contrary to previously published data, we did not find a relationship between RVS and higher mortality in patients with MSSA bacteraemia and we did not find a link with higher complicated bacteraemia rates.
Additional details
Identifiers
- URL
- https://idus.us.es/handle//11441/154727
- URN
- urn:oai:idus.us.es:11441/154727