Vancomycin minimum inhibitory concentration (Mic) creep and its effect on mortality in adult cardiac patients who developed sepsis caused by Staphylococcus Aureus and coagulase- negative staphylococcus
Medical Science Technology, cilt.58, ss.49-55, 2017 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 58
- Basım Tarihi: 2017
- Doi Numarası: 10.12659/mst.905068
- Dergi Adı: Medical Science Technology
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.49-55
- Anahtar Kelimeler: Mortality, Staphylococcus aureus, Vancomycin
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: The aim of our study was to determine the vancomycin MIC creep of the pathogens Staphylococcus aureus and coagulase-negative Staphylococcus (CNS) detected in blood cultures of patients with clinical signs of sepsis and to evaluate its effect on the mortality rate of patients. Material/Methods: The patients with atherosclerotic heart disease, also diagnosed with sepsis, who were in the cardiology and cardiovascular surgery clinics and intensive care units between January 2011 and August 2015, were included in our study retrospectively, and 30-day mortality rates were evaluated. Results: Heteroresistant vancomycin-intermediate Staphylococcus aureus (hVISA) was detected in 57.5% of patients and vancomycin-intermediate Staphylococcus aureus (VISA) was detected in 2.7%. Vancomycin-intermediate CNS (VICNS) was detected 2.2%. According to vancomycin MIC values, S. aureus and S. epidermidis with vancomycin MIC ≥2 µg/mL were higher than vancomycin MIC <2 µg/mL (p=0.04, p=0.006), but S. hominis sups. hominis with vancomycin MIC <2 µg/mL was higher than vancomycin MIC ≥2 µg/mL (p<0.001). The mortality rate in patients with isolated S. aureus with vancomycin MIC=2 µg/mL was much more than with vancomycin MIC <2 µg/mL (p=0.050). The mortality rate in patients with isolated S. haemolyticus with vancomycin MIC ≥4 µg/mL was higher than vancomycin MICs (p=0.021). Conclusions: We found higher mortality rates in patients with sepsis that have isolated hVISA. Determining the vancomycin MIC creep and the rates of hVISA strains in Staphylococci are important for planning treatment of patients with sepsis.