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Evaluation of Vancomycin MICs for the Treatment of MRSA in Bacteremia
Başlık:
Evaluation of Vancomycin MICs for the Treatment of MRSA in Bacteremia
Yazar:
Garcia, Minerva A., author.
ISBN:
9780438079014
Yazar Ek Girişi:
Fiziksel Tanımlama:
1 electronic resource (52 pages)
Genel Not:
Source: Masters Abstracts International, Volume: 57-06M(E).
Advisors: Mrinal Bhattacharjee.
Özet:
This study compares different vancomycin minimal inhibitory concentration (MIC) values obtained via two different lab techniques in order to discuss treatment outcomes in patients with MRSA bacteremia. Since Microscan MIC panels that are currently in use work by the microdilution method and can only provide up to 2.0 MIC -- (16 microg/ml), therefore an alternative method based on E-test was utilized to obtain lower MIC values. Analysis of blood cultures from patients with MRSA from September 2016 - February 2017 was performed. Criteria considered were: Date of Initial Culture, Date of Initial Negative Culture, Microdilution MIC Value vs E-Test MIC Value, Initial Antibiotic vs Final Antibiotic Length of Therapy, Presence of Endocarditis and Treatment Outcomes. For patients with S.aureus bacteremia, higher vancomycin MICs were associated with prolonged bacteremia, longer duration of therapy, treatment failures, and increased mortality. The studies demonstrate a significant correlation between vancomycin susceptibilities and patient outcomes. Greater than 60% of clinical nosocomial S.aureus isolates recovered in ICU are MRSA, that is associated with increased mortality, requires longer duration of antimicrobial therapy, higher healthcare costs, and prolonged hospitalization. Since Vancomycin antibiotic, whose mechanism of action involves inhibition of bacterial cell wall synthesis by binding tightly to D-alanylD-alanine portion of the substrate, is the cornerstone of treatment of patients with MRSA infections, it was the antibiotic of choice for this study. A >90% agreement is considered to be acceptable performance data. Clinical isolates with 1.0 MIC by the microdilution method, also demonstrated MIC of 1.0 by the E-test method. One problem with use of vancomycin is that its MIC for wild type strain can gradually increase with long term use of the antibiotic. Such an increase of MIC, which is known as "creeping MIC" is often undetectable by the Microscan method because it uses serial doubling dilutions of the antibiotic. The purpose of this study was to evaluate Vancomycin "Creeping" MIC by using the E-test method since the method also includes intermediate concentrations of antibiotic. Results showed no MIC creep since none of the E-test experiments exhibited an MIC of 2, only 1 patient showed a match of results obtained by the microdilution and E-test methods. Even though the E-test method is capable of reading 0.5 and 1 MIC but the results read a 2.0, and thus the results are in essential agreement with each other. Conclusion: MICs obtained from the E-test method were more precise since E-test covered the in-between values not available from the microdilution method.
Notlar:
School code: 0198
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Yer Numarası | Demirbaş Numarası | Shelf Location | Lokasyon / Statüsü / İade Tarihi |
---|---|---|---|
XX(696244.1) | 696244-1001 | Proquest E-Tez Koleksiyonu | Arıyor... |
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