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. 1990 Sep;28(9):2064–2068. doi: 10.1128/jcm.28.9.2064-2068.1990

Vancomycin resistance in Staphylococcus haemolyticus causing colonization and bloodstream infection.

L A Veach 1, M A Pfaller 1, M Barrett 1, F P Koontz 1, R P Wenzel 1
PMCID: PMC268104  PMID: 2229388

Abstract

The increase in the incidence of infections due to beta-lactam-resistant coagulase-negative staphylococci has resulted in expanded use of vancomycin for such infections. Despite this, coagulase-negative staphylococci have remained susceptible to vancomycin in recent years. This report describes a strain of Staphylococcus haemolyticus with increased resistance to vancomycin (MIC, 8.0 to 16 micrograms/ml). S. haemolyticus was initially isolated from a patient with acute leukemia and neutropenia in surveillance throat and stool cultures. The microdilution vancomycin MICs for these isolates were 1.0 to 2.0 micrograms/ml. Subsequent S. haemolyticus isolates from the bloodstream and tracheal aspirate occurred in the setting of prolonged empirical vancomycin therapy. MICs for these isolates were 8.0 to 16 micrograms/ml. Further vancomycin resistance (MIC, 32 micrograms/ml) could be selected for in vitro in all four isolates. Restriction endonuclease analysis of plasmid DNA indicated that the isolates were very closely related and likely to be of the same strain. We conclude that colonization with a vancomycin-susceptible strain of S. haemolyticus was subsequently linked to a nosocomial bloodstream infection with an apparently identical strain with intermediate levels of vancomycin resistance. Prolonged empirical vancomycin therapy was temporally associated with this episode.

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Selected References

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  1. Archer G. L. Antimicrobial susceptibility and selection of resistance among Staphylococcus epidermidis isolates recovered from patients with infections of indwelling foreign devices. Antimicrob Agents Chemother. 1978 Sep;14(3):353–359. doi: 10.1128/aac.14.3.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Froggatt J. W., Johnston J. L., Galetto D. W., Archer G. L. Antimicrobial resistance in nosocomial isolates of Staphylococcus haemolyticus. Antimicrob Agents Chemother. 1989 Apr;33(4):460–466. doi: 10.1128/aac.33.4.460. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Karp J. E., Dick J. D., Angelopulos C., Charache P., Green L., Burke P. J., Saral R. Empiric use of vancomycin during prolonged treatment-induced granulocytopenia. Randomized, double-blind, placebo-controlled clinical trial in patients with acute leukemia. Am J Med. 1986 Aug;81(2):237–242. doi: 10.1016/0002-9343(86)90257-3. [DOI] [PubMed] [Google Scholar]
  4. Leclercq R., Derlot E., Duval J., Courvalin P. Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium. N Engl J Med. 1988 Jul 21;319(3):157–161. doi: 10.1056/NEJM198807213190307. [DOI] [PubMed] [Google Scholar]
  5. Martin M. A., Pfaller M. A., Wenzel R. P. Coagulase-negative staphylococcal bacteremia. Mortality and hospital stay. Ann Intern Med. 1989 Jan 1;110(1):9–16. doi: 10.7326/0003-4819-110-1-9. [DOI] [PubMed] [Google Scholar]
  6. Mickelsen P. A., Plorde J. J., Gordon K. P., Hargiss C., McClure J., Schoenknecht F. D., Condie F., Tenover F. C., Tompkins L. S. Instability of antibiotic resistance in a strain of Staphylococcus epidermidis isolated from an outbreak of prosthetic valve endocarditis. J Infect Dis. 1985 Jul;152(1):50–58. doi: 10.1093/infdis/152.1.50. [DOI] [PubMed] [Google Scholar]
  7. Rubin M., Hathorn J. W., Marshall D., Gress J., Steinberg S. M., Pizzo P. A. Gram-positive infections and the use of vancomycin in 550 episodes of fever and neutropenia. Ann Intern Med. 1988 Jan;108(1):30–35. doi: 10.7326/0003-4819-108-1-30. [DOI] [PubMed] [Google Scholar]
  8. Ruoff K. L., Kuritzkes D. R., Wolfson J. S., Ferraro M. J. Vancomycin-resistant gram-positive bacteria isolated from human sources. J Clin Microbiol. 1988 Oct;26(10):2064–2068. doi: 10.1128/jcm.26.10.2064-2068.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Schwalbe R. S., Ritz W. J., Verma P. R., Barranco E. A., Gilligan P. H. Selection for vancomycin resistance in clinical isolates of Staphylococcus haemolyticus. J Infect Dis. 1990 Jan;161(1):45–51. doi: 10.1093/infdis/161.1.45. [DOI] [PubMed] [Google Scholar]
  10. Schwalbe R. S., Stapleton J. T., Gilligan P. H. Emergence of vancomycin resistance in coagulase-negative staphylococci. N Engl J Med. 1987 Apr 9;316(15):927–931. doi: 10.1056/NEJM198704093161507. [DOI] [PubMed] [Google Scholar]
  11. Williamson R., Al-Obeid S., Shlaes J. H., Goldstein F. W., Shlaes D. M. Inducible resistance to vancomycin in Enterococcus faecium D366. J Infect Dis. 1989 Jun;159(6):1095–1104. doi: 10.1093/infdis/159.6.1095. [DOI] [PubMed] [Google Scholar]

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