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Volume 9, Number 6—June 2003
Research

Clinical Implications of Varying Degrees of Vancomycin Susceptilibity in Methicillin-Resistant Staphylococcus aureus Bacteremia1

Mitchell J. Schwaber*†‡Comments to Author , Sharon B. Wright*†, Yehuda Carmeli*†‡, Lata Venkataraman*†, Paola C. DeGirolami*†, Aneta Gramatikova§, Trish M. Perl§, George Sakoulas*†, and Howard S. Gold*†
Author affiliations: *Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; †Harvard Medical School, Boston, Massachusetts, USA; ‡Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; §Johns Hopkins Hospital, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA

Main Article

Figure 2

a) Population analysis of parent isolates and reference strains. PC3, vancomycin- intermediate Staphylococcus aureus (VISA) reference strain (published vancomycin MIC 8 mg/L (19); MIC 4 mg/L by our assay); ATCC, methicillin-resistant S. aureus (MRSA) reference strain ATCC 33591 (MIC 1 mg/L by our assay); clinical isolates exhibiting growth on screening media (MIC in parentheses, in mg/L, followed by MIC of subclone)—302 (1, 4), 354 (0.5, 1), 1150 (1,2), 1203 (1,2); clinical isolates with no grow

Figure 2. a) Population analysis of parent isolates and reference strains. PC3, vancomycin- intermediate Staphylococcus aureus (VISA) reference strain (published vancomycin MIC 8 mg/L (19); MIC 4 mg/L by our assay); ATCC, methicillin-resistant S. aureus (MRSA) reference strain ATCC 33591 (MIC 1 mg/L by our assay); clinical isolates exhibiting growth on screening media (MIC in parentheses, in mg/L, followed by MIC of subclone)—302 (1, 4), 354 (0.5, 1), 1150 (1,2), 1203 (1,2); clinical isolates with no growth on screening media (MIC in parentheses, in mg/L)—328 (1), 736 (1), 744 (1), 1149 (1). Isolates with growth on screening media are represented by solid lines; isolates with no growth are represented by broken lines. Isolates 354 and 1150 were cultured from the same patient, 14 months apart. b) Population analysis of an MRSA bloodstream isolate exhibiting heterogeneously reduced susceptibility to vancomycin, and its subclone, compared with reference strains. ATCC, MRSA reference strain ATCC 33591 (MIC 1 mg/L by our assay); PC3, VISA reference strain (published MIC 8 mg/L (19); MIC 4 mg/L by our assay); 1337, clinical isolate (MIC 1 mg/L); 1337d, subclone of 1337 grown on screening media (MIC 2 mg/L). While the population curve representing 1337d closely resembles that of PC3, this subclone did not meet MIC criteria for VISA. CFU, colony-forming units.

Main Article

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1Presented in part at the 41st Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, Illinois, December 2001.

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