Challenges in the microbiological diagnosis and management of hVISA infections

Cheong, Jenny Wan Sai, Harris, Patrick, Oman, Kimberly and Norton, Robert (2011) Challenges in the microbiological diagnosis and management of hVISA infections. Pathology, 43 4: 357-361. doi:10.1097/PAT.0b013e3283464ca3


Author Cheong, Jenny Wan Sai
Harris, Patrick
Oman, Kimberly
Norton, Robert
Title Challenges in the microbiological diagnosis and management of hVISA infections
Journal name Pathology   Check publisher's open access policy
ISSN 0031-3025
1465-3931
Publication date 2011-06
Sub-type Article (original research)
DOI 10.1097/PAT.0b013e3283464ca3
Open Access Status Not yet assessed
Volume 43
Issue 4
Start page 357
End page 361
Total pages 5
Place of publication London, United Kingdom
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
Aims: To highlight the challenges involved in diagnosing and managing complicated heterogeneous vancomycin intermediate Staphylococcus aureus (hVISA) infections and to improve clinical recognition of such infections.
Methods: A retrospective review of patients with proven hVISA infections was undertaken in two major referral centres of North Queensland from 2006 to 2010. All isolates had population analysis profiling (PAP) done along with hVISA screening performed by the macro-Etest (MET).
Results: Five patients were identified, two of whom died of hVISA-related sepsis. Their population analysis profilingarea- under-the-curve ratio (PAP-AUC) ranged between 0.96 and 1.43.
Conclusions: The identification of hVISA isolates in the diagnostic laboratory presents specific challenges. Clinical failure with vancomycin or MICs to vancomycin of &lee2 mg/ should alert the laboratory to proceed with the more specific methods of METand PAP to identify hVISA or VISA isolates. Alternatives to vancomycin are limited and not always efficacious or tolerated.
Keyword hVISA
Vancomycin resistance
VISA
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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