Evidence for a continuum of decreased vancomycin susceptibility in unselected Staphylococcus aureus clinical isolates.

Evidence for a continuum of decreased vancomycin susceptibility in unselected Staphylococcus aureus clinical isolates.
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未经选择的金黄色葡萄球菌临床分离株万古霉素敏感性连续下降的证据。

DOI:
10.1086/342708
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发表时间:
2002
期刊:
The Journal of infectious diseases
影响因子:
--
通讯作者:
Daum,RobertS
Daum,RobertS
中科院分区:
--
文献类型:
--
作者:
Hussain,FaridM;Boyle-Vavra,Susan;Shete,PriyaB;Daum,RobertS

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一些金黄色葡萄球菌的糖肽最小抑菌浓度(MIC)在敏感范围内,但其亚群可在≥ 4 μg/mL万古霉素上生长。临床实验室方法确定敏感性已被证明是不足以检测这些菌株。在耐甲氧西林的S.金黄色葡萄球菌(MRSA)和甲氧西林敏感菌(methicillin-tensibleS.)225株MRSA和30株MSSA临床分离株中分别有149株(66.2%)和17株(56.6%)在含2 μg/mL万古霉素的脑心浸液(BHI)培养基上生长; 17株(7.5%)MRSA和2株(6.6%)MSSA分离株在含4 μg/mL万古霉素的BHI筛选平板上生长。1株分离株在含6 μg/mL万古霉素的平板上生长。该分离株通过常规检测逃脱检测,但在BHI培养基中检测时,万古霉素MIC为6 μg/mL。当在含有万古霉素的肉汤培养基中孵育时,该分离物也具有降低的Triton X-100诱导的自溶和杀伤,符合糖肽中间体的性质。金黄色的这些观察结果表明,糖肽中间体样S。金黄色葡萄球菌在循环中未被检测到,并且在金黄色葡萄球菌分离株中存在连续的敏感性降低
SomeStaphylococcus aureusisolates have glycopeptide minimal inhibitory concentrations (MICs) in the susceptible range but have subpopulations that grow on ⩾4 μg/mL vancomycin. Clinical laboratory methods for determining susceptibility have proven to be inadequate for detecting these strains. Among methicillin-resistantS. aureus(MRSA) and methicillin-susceptibleS. aureus(MSSA) clinical isolates, 149 (66.2%) of 225 and 17 (56.6%) of 30, respectively, grew on brain-heart infusion (BHI) medium containing 2 μg/mL vancomycin; 17 (7.5%) of the MRSA and 2 (6.6%) of the MSSA isolates grew on BHI screening plates containing 4 μg/mL vancomycin. One isolate grew on plates containing 6 μg/mL vancomycin. This isolate escaped detection by routine testing but had a vancomycin MIC of 6 μg/mL when tested in BHI medium. This isolate also had decreased Triton X-100–induced autolysis and killing when incubated in broth media containing vancomycin, properties accorded to glycopeptide-intermediateS. aureusisolates. These observations suggest that glycopeptide-intermediate–likeS. aureusisolates are circulating undetected and that a continuum of decreased susceptibility exists in unselected isolates
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