TABLE 4

Clinical, microbiological, and molecular characteristics of hVISA bacteremia patients, according to MLST result

Characteristic of patients or isolatesNo. (%) of hVISA bacteremia patients with STa
ST5 (n = 89)ST72 (n = 16)ST239 (n = 13)
Age (yr), median (IQR)67 (59–73)60 (54–73)55 (48–64)
Male68 (77.5)8 (50.0)11 (84.6)
Nosocomial infection79 (88.8)7 (43.8)9 (69.2)
Underlying disease/condition
    Solid tumor36 (40.4)7 (43.8)1 (7.7)
    Hematologic malignancy3 (3.4)1 (6.3)1 (7.7)
    Diabetes mellitus26 (29.2)6 (37.5)3 (23.1)
    End-stage renal disease11 (12.4)2 (12.5)1 (7.7)
    Liver cirrhosis7 (7.9)3 (18.8)1 (7.7)
    Immunosuppressant use22 (24.7)3 (18.8)5 (38.5)
McCabe and Jackson criteria
    Ultimately or rapidly fatal diseaseb29 (32.6)7 (43.8)4 (30.8)
Charlson comorbidity index, median (IQR)3 (1–4)3 (2.5–5.5)2 (0–4)
APACHE II score, median (IQR)18 (13–25)13 (10–19.5)15 (10–19.5)
Pitt bacteremia score, median (IQR)1 (0–4)1 (0–1.5)1 (0–2)
Septic shock19 (21.3)2 (12.5)1 (7.7)
Type of infection
    Persistent bacteremia (≥7 days)29 (32.6)4 (25.0)4 (30.8)
    Metastatic infection16 (18.0)8 (50.0)2 (15.4)
    Infective endocarditis8 (9.0)2 (12.5)1 (7.7)
    Catheter-related infection46 (51.7)4 (25.0)8 (61.5)
    Pneumonia10 (11.2)1 (7.7)
    Skin and soft tissue infection2 (2.2)1 (6.3)2 (15.4)
    Bone and joint infection4 (4.5)2 (12.5)
    Postoperative wound infection8 (9.0)1 (7.7)
    Primary bacteremia9 (10.1)4 (25.0)
All-cause mortality31 (34.8)4 (25.0)1 (7.7)
Vancomycin MIC (Etest)
    ≤1.0 mg/liter18 (20.2)2 (12.5)3 (23.1)
    1.5 mg/liter37 (41.6)5 (31.3)7 (53.8)
    ≥2.0 mg/liter34 (38.2)9 (56.3)3 (23.1)
PAP-AUC ratio,c median (IQR)1.01 (0.97–1.07)0.98 (0.95–1.08)1.04 (1.00–1.10)
SCCmec typedIIIVIII
agr genotypeeIIII
agr dysfunction86 (96.6)1 (6.3)9 (69.2)
Virulence genef
    map/eap1 (1.1)1 (6.3)11 (84.6)
    sdrC86 (96.6)6 (37.5)13 (100)
    sea1 (1.1)1 (6.3)12 (92.3)
    sec80 (89.9)1 (7.7)
    seg87 (97.8)15 (93.8)2 (15.4)
    sei88 (98.9)14 (87.5)
    sek1 (7.9)1 (6.3)11 (84.6)
    sel87 (97.8)4 (25.0)2 (15.4)
    sem87 (97.8)15 (93.8)1 (7.7)
    sen88 (98.9)15 (93.8)2 (15.4)
    seo88 (98.9)15 (93.8)2 (15.4)
    sep2 (2.2)
    seq11 (84.6)
    tst84 (94.4)1 (6.3)
  • a Data are presented as the number of patients with hVISA bacteremia and the indicated ST (with the corresponding percentage shown in parentheses), unless otherwise specified. IQR, interquartile range.

  • b Of 118 patients, only 1 (in the ST72 group) had rapidly fatal disease.

  • c From the population analysis profile, the AUC for the test isolate versus that for Mu3.

  • d The SCCmec type associated with the ST.

  • e The agr genotype associated with the ST.

  • f All isolates had fnbA, fnbB, clfA, clfB, and icaA. More than 90% of ST5, ST72, and ST239 isolates had bbp, ebpS, sdrD, sdrE, lukE-lukD, hla, hld, and hlg-2. No isolates had cna, seb, sed, see, seh, sej, eta, etb, hlg, pvl, or edin.