Journal Article

Treatment Outcomes for Serious Infections Caused by Methicillin-Resistant <i>Staphylococcus aureus</i> with Reduced Vancomycin Susceptibility

Benjamin P. Howden, Peter B. Ward, Patrick G. P. Charles, Tony M. Korman, Andrew Fuller, Philipp du Cros, Elizabeth A. Grabsch, Sally A. Roberts, Jenny Robson, Kerry Read, Narin Bak, James Hurley, Paul D. R. Johnson, Arthur J. Morris, Barrie C. Mayall and M. Lindsay Grayson

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 4, pages 521-528
Published in print February 2004 | ISSN: 1058-4838
Published online February 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/381202
Treatment Outcomes for Serious Infections Caused by Methicillin-Resistant Staphylococcus aureus with Reduced Vancomycin Susceptibility

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Although infections caused by methicillin-resistant Staphylococcus aureus with reduced vancomycin susceptibility (SA-RVS) have been reported from a number of countries, including Australia, the optimal therapy is unknown. We reviewed the clinical features, therapy, and outcome of 25 patients with serious infections due to SA-RVS in Australia and New Zealand. Eight patients had endocarditis, 9 had bacteremia associated with deep-seated infection, 6 had osteomyelitis or septic arthritis, and 2 had empyema. All patients had received vancomycin before the isolation of SA-RVS, and glycopeptide treatment had failed for 19 patients (76%). Twenty-one patients subsequently received active treatment, which was effective for 16 patients (76%). Eighteen patients received linezolid, which was effective in 14 (78%), including 4 patients with endocarditis. Twelve patients received a combination of rifampicin and fusidic acid. Surgical intervention was required for 15 patients (60%). Antibiotic therapy, especially linezolid with or without rifampicin and fusidic acid, in conjunction with surgical debulking is effective therapy for the majority of patients with serious infections (including endocarditis) caused by SA-RVS.

Journal Article.  3713 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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