Vancomycin MIC creep in MRSA blood culture isolates from Germany: a regional problem?

Eur J Clin Microbiol Infect Dis. 2011 May;30(5):677-83. doi: 10.1007/s10096-010-1140-7. Epub 2011 Jan 13.

Abstract

The aim of this study was to assess the vancomycin MIC distribution for MRSA blood culture isolates over a period of six years in Germany. The study examined 287 MRSA isolates from blood cultures collected at several hospitals in two German cities between 2004 and 2009. The vancomycin MIC was determined by Etest. Genotypic features of the MRSA strains with vancomycin MIC ≥ 1 mg/L were determined by semiautomated repetitive-sequence-based polymerase chain reaction. The range of vancomycin MIC as determined by Etest was 0.25 to 2.0 mg/L. The geometric mean MIC increased by 1.34-fold in city A over the study period (p < 0.05), but there was no meaningful change in city B (a 1.09-fold increase, p > 0.05). Furthermore, in city A a shift in vancomycin MICs occurred as an increase in the percentage of isolates with MIC ≥ 1 mg/L from period one (2004-2006) to period two (2007-2009) (p < 0.0001). Typing results showed that in city A a single clone was predominant (55% of the creep isolates). In this study, the creep phenomenon seems to be a regional problem. We suggest that all hospitals should monitor their local status of elevated vancomycin MICs in invasive MRSA isolates.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Bacteremia / epidemiology*
  • Bacteremia / microbiology
  • Bacterial Typing Techniques
  • Blood / microbiology*
  • Cluster Analysis
  • Genotype
  • Germany / epidemiology
  • Hospitals
  • Humans
  • Interspersed Repetitive Sequences
  • Methicillin-Resistant Staphylococcus aureus / classification
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • Methicillin-Resistant Staphylococcus aureus / genetics
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Microbial Sensitivity Tests
  • Molecular Epidemiology
  • Molecular Typing
  • Polymerase Chain Reaction
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology
  • Vancomycin / pharmacology*
  • Vancomycin Resistance*

Substances

  • Anti-Bacterial Agents
  • Vancomycin