Vancomycin heteroresistance (hVISA) in MRSA links to treatment failure and supports a revised PAP-AUC threshold.

ABSTRACT: Heteroresistance to vancomycin among methicillin-resistant Staphylococcus aureus (MRSA) remains a diagnostic and therapeutic problem in clinical microbiology. In this prospective cohort study of 842 adult patients with MRSA bacteremia in S. Korea, we investigate the prevalence, risk factors, and clinical implications of the heteroresistant vancomycin-intermediate S. aureus (hVISA) phenotype. The hVISA phenotype is detected in 22% of cases. Multivariable regression analysis reveals strong positive associations between hVISA and hospital-acquired infection, prior anti-MRSA therapy, vancomycin exposure, and particularly vancomycin MIC (odds ratio 15.2 per 1 mg/L increase, p < 0.001). Strikingly, patients infected with hVISA strains have a lower 90-day mortality compared to those with fully su

SUBMITTER: Fatsis-Kavalopoulos N 

PROVIDER: S-EPMC12717272 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature