14th ICID - Poster Abstracts - International Society for Infectious ...

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When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 74.010 Session: Antibiotic Resistance: Gram-Positive Date: Friday, March 12, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Trend of vancomycin MIC values among MRSA clinical isolates and association with patient outcome K. A. Kincaid, J. M. Koo, S. M. Borchardt, T. S. Lo Veterans Affairs Medical Center, Fargo, ND, USA Background: Methicillin-resistant Staphylococcus aureus (MRSA) has become a common cause of nosocomial and community-acquired infection. Vancomycin has become the drug of choice given the emergence of MRSA; however, studies have reported an increase in the vancomycin minimum inhibitory concentration (MIC) and vancomycin treatment failure despite MICs within the susceptible range (2 μg/mL). Limited studies have examined whether this increase in vancomycin MIC is associated with patient outcome. Methods: We reviewed the medical records of patients diagnosed with MRSA bloodstream or lower extremity wound infection from January 1, 1998 through December 31, 2008. Bivariate and multivariate analyses were conducted to examine the association between vancomycin MIC and other covariates. Results: 97 patients were diagnosed with a MRSA infection; 65% (63/97) of patients had a bloodstream infection and 35% (34/97) of patients had a wound infection. From 1998 to 2003, MRSA with a low vancomycin MIC (1 g/mL) were in the majority; however, from 2004 to 2008, MRSA with a high MIC (=2 g/mL) were in the majority. Therefore, over time, there was a significant upward trend in vancomycin MIC values (p=0.01). Logistic regression analysis revealed that a high vancomycin MIC was significantly associated with a past medical history of malignancy (p=0.04) and death within 30 days of infection (p=0.04) compared to a low vancomycin MIC. Conclusion: Our study has shown (1) vancomycin MIC values have displayed an upward ‘creep’ over time, and (2) high MIC values of vancomycin is significantly related to a past medical history of malignancy as well as higher mortality within 30 days of MRSA infection. Further prospective studies are needed to examine the clinical significance of an upward ‘creep’ in vancomycin MIC values.
When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 74.011 Session: Antibiotic Resistance: Gram-Positive Date: Friday, March 12, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Prevalence of Methicillin Resistant Staphylococcus aureus (MRSA) in tertiary referral hospital in Nepal K. Sapkota 1 , S. R. Basnyat 1 , C. D. Shrestha 2 , J. Shrestha 2 , S. P. Dumre 3 , N. Adhikari 1 1 Kantipur College of Medical Science, Kathmandu, Nepal, 2 National Academy of Medical Sciences, Kathmandu, Nepal, 3 Thammasat University, Faculty of Allied Health Sciences, Pathumthani, 12121, Thailand Background: Methicillin-resistant S. aureus (MRSA) was first detected in the 1960s, and since that time it has spread rapidly worldwide, becoming a leading cause of nosocomial infection. Because MRSA are also resistant to many antibiotics, the infections caused by them are particularly difficult to treat. Indiscriminate use of antibiotics both in hospital settings and in community may aid in higher prevalence of MRSA in a country like Nepal. Methods: A total of 4690 clinical samples were microbiologically processed for the growth of S. aureus in tertairy referral hospital in Kathmandu, Nepal. Susceptibility testing was performed in Mueller Hinton agar medium at 35oC. Results: 264 S. aureus were recovered from the clinical samples. Among the positive isolates, 73.1% (n=193) isolates were from outpatients, whereas 26.9% (n=71) were from admitted patients. We found 31.1% (82/264) S. aureus to be methicillin resistant. Among a total of 71 S. aureus isolated from admitted patients, 46.5% (n=33) were MRSA whereas among 193 S. aureus isolated from outpatient , only 25.4% (n=49) were MRSA. The association between the MRSA occurrence in admitted patient as compared to outpatient was found to be statistically significant (2 =10.26; P =
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