Vancomycin Heteroresistance and Clinical Outcomes in Coagulase-Negative Staphylococcal Bloodstream Infections.

Vancomycin Heteroresistance and Clinical Outcomes in Coagulase-Negative Staphylococcal Bloodstream Infections. Antimicrob Agents Chemother. 2020 Aug 17;: Authors: Dao TH, Alsallaq R, Parsons J, Ferrolino J, Hayden RT, Rubnitz JE, Rafiqullah IM, Robinson DA, Margolis EB, Rosch JW, Wolf J Abstract Coagulase-negative staphylococci (CoNS) are a common etiology of serious and recurrent infections in immunocompromised patients. Although most isolates appear susceptible to vancomycin, a single strain might have a subpopulation of resistant bacteria. This phenomenon is termed heteroresistance and may adversely affect the response to treatment. A retrospective cohort study was performed of pediatric patients with leukemia treated at St. Jude Children's Research Hospital who developed CoNS central line-associated bloodstream infection (CLABSI). Available isolates were sequenced and tested for vancomycin heteroresistance by population analysis profiling. Risk factors for heteroresistance and the association of heteroresistance with treatment failure (death or relapse of infection) or poor clinical response to vancomycin therapy (treatment failure or persistent bacteremia after vancomycin initiation) were evaluated. For 65 participants with CoNS CLABSI, 62 initial isolates were evaluable, of which 24 (39%) were vancomycin heteroresistant. All heteroresistant isolates were of Staphylococcus epidermidis and comprised multiple sequence types. Parti...
Source: Antimicrobial Agents and Chemotherapy - Category: Microbiology Authors: Tags: Antimicrob Agents Chemother Source Type: research