金黄色葡萄球菌中异质性万古霉素耐药并不预示着万古霉素压力下万古霉素耐药的发展。

Heterogeneous vancomycin resistance in Staphylococcus aureus does not predict development of vancomycin resistance upon vancomycin pressure.

机构信息

Centre National de Référence des Staphylocoques, Hospices Civils de Lyon, Lyon, France.

Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, Université Lyon 1, ENS de Lyon, Lyon, France.

出版信息

J Antimicrob Chemother. 2022 Mar 31;77(4):1032-1035. doi: 10.1093/jac/dkab488.

DOI:10.1093/jac/dkab488

PMID:35022718

Abstract

BACKGROUND

It is unclear whether Staphylococcus aureus with heterogeneous intermediate vancomycin resistance (hVISA) can develop vancomycin resistance faster than vancomycin-susceptible S. aureus (VSSA) strains.

METHODS

We compared the kinetics of vancomycin MIC increase for 15 days of sustained in vitro vancomycin exposure for clinical hVISA (n = 12) and VSSA (n = 24) isolates, as well as for reference strains Mu3 (hVISA) and ATCC 29213 (VSSA). Clinical isolates were categorized as hVISA using the population analysis profile method. MICs were monitored for 15 days and the rate of MIC increase under exposure, for each strain, was evaluated in a linear regression model relative to time.

RESULTS

All isolates acquired vancomycin resistance upon exposure. Vancomycin MICs increased faster for VSSA compared with hVISA isolates (P < 0.01).

CONCLUSIONS

The hVISA phenotype does not correspond to an enhanced adaptation potential to in vitro vancomycin pressure.

摘要

背景

目前尚不清楚具有异质性中间万古霉素耐药性（hVISA）的金黄色葡萄球菌是否比万古霉素敏感的金黄色葡萄球菌（VSSA）菌株更快地发展为万古霉素耐药性。

方法

我们比较了 15 天持续体外万古霉素暴露对 12 株临床 hVISA（n = 12）和 24 株 VSSA（n = 24）分离株以及参考菌株 Mu3（hVISA）和 ATCC 29213（VSSA）的万古霉素 MIC 增加动力学。使用群体分析谱法对临床分离株进行 hVISA 分类。监测 MIC 达 15 天，并在暴露条件下，用线性回归模型相对于时间评估每个菌株的 MIC 增加率。