INTENSIVIST Volume 11, Issue 1 (January 2019)

Reduced susceptibility of MRSA to vancomycin Haruaki WAKATAKE 1 1Emergency Medical Center St. Marianna University School of Medicine Yokohama City Seibu Hospital pp.20-26
Published Date 2019/1/1
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Reduced susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) to vancomycin may occur via plasmid-mediated horizontal gene transfer (as in the case of vancomycin-resistant S. aureus [VRSA]), cell wall thickening alterations (as in the case of vancomycin-intermediate S. aureus [VISA]), or increased vancomycin minimum inhibitory concentration (known as MIC creep). Even with vancomycin sensitive Staphylococcus aureus with low MIC, certain populations such as hVISA, BIVR, or slow VISA, may result in vancomycin treatment failure. MIC creep indicates a phenomenon that the susceptibility to vancomycin decreases with the passage of time, but this may be a phenomenon related to remeasurement of long-term frozen specimens, inconsistencies in measurement method or regionality. Based on the PK / PD theory of antimicrobial therapy, the efficacy of vancomycin correlates with the value of AUC/MIC. It is necessary to consider not only the susceptibility result but also the value of MIC when considering the use of vancomycin.

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11巻1号 (2019年1月)
電子版ISSN 2186-7852 印刷版ISSN 1883-4833 メディカル・サイエンス・インターナショナル