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Colegio de Medicina Interna de México.

2014, Number 2

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Med Int Mex 2014; 30 (2)

Is it Time to Save Vancomycin in the Trunk of Memories?

Ayala-Gaytán JJ, Alemán-Bocanegra MC, Guajardo-Lara CE, Valdovinos-Chávez SB

Language: Spanish
References: 21
Page: 140-145
PDF size: 505.81 Kb.


ABSTRACT

Background: Recently the susceptibility cutoff point of S. aureus to vancomycin was reduced 4 to 2 mg/mL due to poor response, now questions whether a further reduction should be done.
Objective: To review the frequency of isolations of methicillin and vancomycin resistant strains of S. aureus in our hospital.
Material and method: A retrospective, cross-sectional and descriptive study was done; within 3 years we isolated strains of S. aureus and MICs to vancomycin were obtained with the MicroScan system (Dade-Behring, Sacramento, CA) according to the Clinical and Laboratory Standards Institute.
Results: Seven (13.2%) out of 53 MSSA and 17 (19.1%) out of 89 MRSA strains gave vancomycin MIC of 2 µg/mL, MIC was not greater in any case. From these 24 samples, 10 (41.6%) were from subcutaneous abscesses, 8 (33.3%) from bronchial lavage, 4 from blood cultures and two from joint fluid.
Conclusions: The resistance in our isolates of S. aureus to methicillin is high, and important the coexistence of meticyline-resistant and -susceptible S. aureus with vancomycin MICs of 2 µg/mL. We found no strains with MICs ≥ 4 µg/mL. The laboratory must be aware of the strains with vancomycin MIC › 2 µg/mL, and this information should be confirmed in cases of severe infections.


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