TABLE 2

Microbiological characteristics and clinical management of patients with hVISA bacteremia, according to treatment outcomea

Characteristic of patients or isolatesDeceased patients (n = 38)Surviving patients (n = 83)All patients (n = 121)P value
No. patients with eradicable focus23 (60.5)59 (71.1)82 (67.8)0.286
No. showing removal of eradicable focus/total no. with eradicable focus (%)22/23 (95.7)52/59 (88.1)74/82 (90.2)0.431
No. who received delayed antibiotic treatmentb5 (13.2)16 (19.3)21 (17.4)0.409
No. who received initial treatment with vancomycin32 (84.2)76 (91.6)108 (89)0.342
No. with vancomycin trough levelc < 15 mg/liter/total no. with vancomycin trough level monitoring8/29 (27.6)25/65 (38.5)33/94 (35.1)0.308
Definitive antibiotic treatment
    Vancomycin29 (76.3)53 (63.9)82 (67.8)0.173
    Teicoplanin3 (7.9)4 (4.8)7 (5.8)0.677
    Linezolid6 (15.8)26 (31.3)32 (26.4)0.072
hVISA isolate characteristics
    Vancomycin MIC (Etest)0.645
        ≤1.0 mg/liter7 (18.4)16 (19.3)23 (19.0)
        1.5 mg/liter14 (36.8)37 (44.6)51 (42.1)
        ≥2.0 mg/liter17 (44.7)30 (36.1)47 (38.8)
    PAP-AUC ratio,d median (IQR)1.01 (0.97–1.04)1.02 (0.97–1.08)1.02 (0.97–1.07)0.182
    SCCmec typee
        I1 (1.2)1 (0.8)>0.999
        II31 (81.6)57 (68.7)88 (72.7)0.139
        III1 (2.6)13 (15.7)14 (11.6)0.062
        IV5 (13.2)11 (13.3)16 (13.2)0.999
    Multilocus sequence type
        ST531 (81.6)58 (69.9)89 (73.6)0.176
        ST724 (10.5)12 (14.5)16 (13.2)0.553
        ST2391 (2.6)12 (14.5)13 (10.7)0.061
        Otherf2 (5.3)1 (1.2)3 (2.5)0.232
    agr genotypeg0.288
        I6 (15.8)23 (27.7)29 (24.0)
        II31 (81.6)58 (69.9)89 (73.6)
    agr dysfunction32 (84.2)64 (77.1)96 (79.3)0.370
  • a Data are presented as the number of patients (with the corresponding percentage shown in parentheses), unless otherwise specified. IQR, interquartile range.

  • b Administration of adequate antibiotic 2 days after bacteremia onset.

  • c Mean trough level during the first 7 days of vancomycin therapy.

  • d Ratio of the AUC for the test isolate and the AUC for Mu3.

  • e For one isolate, SCCmec was not detected by PCR.

  • f Two isolates were ST254 and one was ST1.

  • g Three isolates were nontypeable.