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Activities of vancomycin, teicoplanin and linezolid against bacteraemic methicillin-resistant Staphylococcus aureus strains in Gauteng, South Africa
Critical Care volume 13, Article number: P309 (2009)
This study aims to describe the vancomycin, teicoplanin and linezolid susceptibility patterns of methicillin-resistant Staphylococcus aureus (MRSA) blood culture isolates from patients in the private sector in Gauteng, South Africa. Screening tests for heterogeneous glycopeptide intermediate S. aureus (hGISA) strains were also performed. MRSA isolates with vancomycin minimum inhibitory concentrations (MICs) of 1 to 2 mg/l are associated with worse clinical outcomes . Furthermore, hGISA infections are associated with clinical failure of glycopeptide therapy .
MICs for vancomycin, teicoplanin and linezolid were performed on 50 randomly collected MRSA strains from blood cultures according to Clinical Laboratory Standards Institute guidelines. Screening for hGISA was performed using the Etest (AB BIODISK) Macromethod as well as the new Etest Glycopeptide Resistance Detection.
The results of susceptibility patterns are depicted in Table 1. Fifty percent (25/50) and 20% (10/50) of the strains screened positive for hGISA using the Etest Macromethod and Etest Glycopeptide Resistance Detection, respectively.
We recommend that clinically relevant MRSA isolates be reported with MICs for vancomycin, teicoplanin and linezolid, and that glycopeptide treatment failure warrants further testing of the MRSA isolate to detect possible hGISA. Ideally hGISA should be confirmed by population analysis profile testing, which was not available to us for this study.
Soriano A, et al.: Influence of vancomycin MIC on the treatment of MRSA bacteremia. Clin Infect Dis 2007, 46: 193-200. 10.1086/524667
Charles PGP, et al.: Clinical features associated with bacteremia due to heterogeneous vancomycin-intermediate Staphylococcus aureus . Clin Infect Dis 2004, 38: 448-451. 10.1086/381093
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Botha, M., Coetzee, J., Feldman, C. et al. Activities of vancomycin, teicoplanin and linezolid against bacteraemic methicillin-resistant Staphylococcus aureus strains in Gauteng, South Africa. Crit Care 13 (Suppl 1), P309 (2009). https://doi.org/10.1186/cc7473