Clonal spread of Staphylococcus aureus heterogeneously resistant to vancomycin in a university hospital in Korea.

Journal of Clinical Microbiology
Mi-Na KimChik Hyun Pai

Abstract

Since vancomycin-intermediate Staphylococcus aureus (VISA) was first reported in Japan in 1997, there has been great concern that heterogeneous vancomycin-intermediate S. aureus (hetero-VISA) is the putative precursor of VISA. To investigate the prevalence, clinical significance, and molecular epidemiology of S. aureus with reduced susceptibility to vancomycin, all consecutive isolates of S. aureus isolated from clinical specimens from December 1998 to August 1999 at Asan Medical Center were screened for VISA and hetero-VISA by using brain heart infusion agar containing 4 microg of vancomycin/ml. Screen-positive isolates were confirmed by susceptibility testing and population analysis of subpopulations with reduced susceptibility to vancomycin. The isolates confirmed as hetero-VISA were typed by pulsed-field gel electrophoresis (PFGE). Medical records were reviewed to evaluate the clinical significance and risk factors for the acquisition of hetero-VISA. Of the 4,483 isolates that were tested, 53 were screen positive; no VISA was detected, but 24 isolates (0.54%) from 22 patients were hetero-VISA. All but two strains appeared to be clones of the Korean VISA strain, AMC11094, in the PFGE analysis. A total of 18 patients were in ...Continue Reading

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