Investigation of heteroresistant vancomycin intermediate Staphylococcus aureus among MRSA isolates

Introduction: Heteroresistant vancomycin intermediate Staphylococcus aureus (hVISA) testing is recommended when therapeutic failure is suspected in the clinics. In our research, we aimed to investigate the prevalence of hVISA among methicilline-resistant S. aureus (MRSA) isolates in our university...

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Main Authors: Deniz Gazel, Mehmet Erinmez, Ayşe Büyüktaş Manay, Yasemin Zer
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2021-01-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/12799
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author Deniz Gazel
Mehmet Erinmez
Ayşe Büyüktaş Manay
Yasemin Zer
author_facet Deniz Gazel
Mehmet Erinmez
Ayşe Büyüktaş Manay
Yasemin Zer
author_sort Deniz Gazel
collection DOAJ
description Introduction: Heteroresistant vancomycin intermediate Staphylococcus aureus (hVISA) testing is recommended when therapeutic failure is suspected in the clinics. In our research, we aimed to investigate the prevalence of hVISA among methicilline-resistant S. aureus (MRSA) isolates in our university hospital and compared three methods for detection of hVISA. Methodology: One hundred MRSA clinical isolates were collected in our medical microbiology laboratory between 01.04.2018 and 01.10.2019. For screening of hVISA, we used two screening agar plates and used one commercial medium; brain heart infusion agar (BHI) plates containing 4 µg/mL vancomycin and 16 g/Lt casein (BHIA-VC; Satola’s test), BHI agar plates containing 4 µg/mLvancomycin (BHIAV), and commercially obtained vancomycin resistant Enterococci (VRE) agar for detetection of hVISA. Colonies which could grow on plates were counted manually at 24th and 48th hours. Results: Among 100 MRSA isolates, 43 (43%) were found as hVISA using Satola’s test. BHIAV and VRE agar screening test results were found 70% and 4%, respectively. Finally, at the step, MIC values of 20 (47%) hVISA isolates reduced to 2 µg/mL after sub culturing for the gradient test. Conclusions: We found higher rates of hVISA comparing other studies in Turkey. Both VRE agar and BHIAV screening test failed to detect hVISA properly. Meropenem in combination with vancomycin inhibited the growth of 90% hVISA isolates in our study.
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publisher The Journal of Infection in Developing Countries
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spelling doaj-art-27e8eaaaf394436bb6d5ced66f7087412025-08-20T02:57:13ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802021-01-01150110.3855/jidc.12799Investigation of heteroresistant vancomycin intermediate Staphylococcus aureus among MRSA isolatesDeniz Gazel0Mehmet Erinmez1Ayşe Büyüktaş Manay2Yasemin Zer3Department of Medical Microbiology, School of Medicine, Gaziantep University, Gaziantep, TurkeyDepartment of Medical Microbiology, School of Medicine, Gaziantep University, Gaziantep, TurkeyDepartment of Medical Microbiology, School of Medicine, Gaziantep University, Gaziantep, TurkeyDepartment of Medical Microbiology, School of Medicine, Gaziantep University, Gaziantep, Turkey Introduction: Heteroresistant vancomycin intermediate Staphylococcus aureus (hVISA) testing is recommended when therapeutic failure is suspected in the clinics. In our research, we aimed to investigate the prevalence of hVISA among methicilline-resistant S. aureus (MRSA) isolates in our university hospital and compared three methods for detection of hVISA. Methodology: One hundred MRSA clinical isolates were collected in our medical microbiology laboratory between 01.04.2018 and 01.10.2019. For screening of hVISA, we used two screening agar plates and used one commercial medium; brain heart infusion agar (BHI) plates containing 4 µg/mL vancomycin and 16 g/Lt casein (BHIA-VC; Satola’s test), BHI agar plates containing 4 µg/mLvancomycin (BHIAV), and commercially obtained vancomycin resistant Enterococci (VRE) agar for detetection of hVISA. Colonies which could grow on plates were counted manually at 24th and 48th hours. Results: Among 100 MRSA isolates, 43 (43%) were found as hVISA using Satola’s test. BHIAV and VRE agar screening test results were found 70% and 4%, respectively. Finally, at the step, MIC values of 20 (47%) hVISA isolates reduced to 2 µg/mL after sub culturing for the gradient test. Conclusions: We found higher rates of hVISA comparing other studies in Turkey. Both VRE agar and BHIAV screening test failed to detect hVISA properly. Meropenem in combination with vancomycin inhibited the growth of 90% hVISA isolates in our study. https://jidc.org/index.php/journal/article/view/12799S. aureusMRSAhVISAscreeningVRE agar
spellingShingle Deniz Gazel
Mehmet Erinmez
Ayşe Büyüktaş Manay
Yasemin Zer
Investigation of heteroresistant vancomycin intermediate Staphylococcus aureus among MRSA isolates
Journal of Infection in Developing Countries
S. aureus
MRSA
hVISA
screening
VRE agar
title Investigation of heteroresistant vancomycin intermediate Staphylococcus aureus among MRSA isolates
title_full Investigation of heteroresistant vancomycin intermediate Staphylococcus aureus among MRSA isolates
title_fullStr Investigation of heteroresistant vancomycin intermediate Staphylococcus aureus among MRSA isolates
title_full_unstemmed Investigation of heteroresistant vancomycin intermediate Staphylococcus aureus among MRSA isolates
title_short Investigation of heteroresistant vancomycin intermediate Staphylococcus aureus among MRSA isolates
title_sort investigation of heteroresistant vancomycin intermediate staphylococcus aureus among mrsa isolates
topic S. aureus
MRSA
hVISA
screening
VRE agar
url https://jidc.org/index.php/journal/article/view/12799
work_keys_str_mv AT denizgazel investigationofheteroresistantvancomycinintermediatestaphylococcusaureusamongmrsaisolates
AT mehmeterinmez investigationofheteroresistantvancomycinintermediatestaphylococcusaureusamongmrsaisolates
AT aysebuyuktasmanay investigationofheteroresistantvancomycinintermediatestaphylococcusaureusamongmrsaisolates
AT yaseminzer investigationofheteroresistantvancomycinintermediatestaphylococcusaureusamongmrsaisolates