Heterogeneous vancomycin-intermediate susceptibility in a community-associated methicillin-resistant Staphylococcus aureus epidemic clone, in a case of Infective Endocarditis in Argentina

CLAUDIA SOLA; RICARDO LAMBERGHINI; MARCOS CIARLANTINI ; ANA L EGEA ; PATRICIA GONZALEZ; ELDA G DIAZ; VANINA HUERTA; JOSE GONZALEZ; ALEJANDRA CORSO; MARIO VILARO; JUAN P PETITI; ALICIA TORRES; ANA VINDEL; BOCCO, JOSE LUIS

Annals of clinical microbiology and antimicrobials

BioMed Central

Lugar: London ; Año: 2011 vol. 10 p. 15 - 15

1476-0711

h4>Background Community-Associated Methicillin Resistant Staphylococcus aureus (CA-MRSA) has traditionally been related to skin and soft tissue infections in healthy young patients. However, it has now emerged as responsible for severe infections worldwide, for which vancomycin is one of the mainstays of treatment. Infective endocarditis (IE) due to CA-MRSA with heterogeneous vancomycin-intermediate susceptibility-(h-VISA) has been recently reported, associated to an epidemic USA 300 CA-MRSA clone. Case presentation We describe the occurrence of h-VISA phenotype in a case of IE caused by a strain belonging to an epidemic CA-MRSA clone, distinct from USA300, for the first time in Argentina. The isolate h-VISA (SaB2) was recovered from a patient with persistent bacteraemia after a 7-day therapy with vancomycin, which evolved to fatal case of IE complicated with brain abscesses. The initial isolate-(SaB1) was fully vancomycin susceptible (VSSA). Although MRSA