Related Experiment Video

Updated: May 25, 2026

A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically
11:28

A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically

Published on: September 9, 2015

The clinical significance of vancomycin minimum inhibitory concentration in Staphylococcus aureus infections: a

S J van Hal1, T P Lodise, D L Paterson

  • 1Department of Microbiology and Infectious Diseases, Sydney South West Pathology Services-Liverpool, South Western Sydney Local Health Network, New South Wales, Sydney, Australia. S.VanHal@uws.edu.au

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|February 4, 2012
PubMed
Abstract

Insights

Higher vancomycin minimum inhibitory concentration (MIC) levels correlate with increased mortality in methicillin-resistant Staphylococcus aureus (MRSA) infections, particularly bloodstream infections. Further research is needed to explore alternative treatments for MRSA with elevated vancomycin MIC.

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Pharmacology

Background:

  • Emerging evidence suggests vancomycin may be less effective against serious methicillin-resistant Staphylococcus aureus (MRSA) infections when minimum inhibitory concentration (MIC) values are high.
  • This review examines the strength of the association between vancomycin MIC and clinical outcomes in MRSA infections.

Purpose of the Study:

  • To review and analyze studies investigating the relationship between vancomycin MIC values and treatment outcomes or mortality in patients with MRSA infections.
  • To determine the clinical significance of elevated vancomycin MIC in MRSA infections.

Main Methods:

  • A systematic literature search was conducted for studies published between January 1996 and August 2011.
  • Relevant studies were analyzed according to Cochrane guidelines, with 22 studies included in a final meta-analysis of 270 identified articles.

Main Results:

  • A significant association was found between vancomycin MIC and mortality in MRSA infections (OR, 1.64; 95% CI, 1.14-2.37; P < .01).
  • This association was particularly strong for bloodstream infections (BSIs) and isolates with a vancomycin MIC of 2 μg/mL by Etest.
  • Vancomycin MIC was also significantly associated with treatment failure (OR, 2.69; 95% CI, 1.60-4.51; P < .01).

Conclusions:

  • High vancomycin MIC is linked to increased mortality in MRSA BSIs.
  • Institutions should consider performing Etest MICs for all MRSA BSI isolates.
  • While vancomycin efficacy is questioned, alternative antibiotics lack supporting data for improved survival; further research is needed.

More Related Videos

Biosensor for Detection of Antibiotic Resistant Staphylococcus Bacteria14:04

Biosensor for Detection of Antibiotic Resistant Staphylococcus Bacteria

Published on: May 8, 2013

Related Concept Videos

Clinical Significance of Antibiotic Resistance01:25

Clinical Significance of Antibiotic Resistance

Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...
Mechanism of Antibiotic Resistance in MRSA01:25

Mechanism of Antibiotic Resistance in MRSA

Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and acquisition...
Staphylococcal Skin Infections01:29

Staphylococcal Skin Infections

Staphylococcus aureus is a Gram-positive coccus that resides harmlessly on the skin and mucous membranes of healthy individuals. When the skin barrier is breached, it can shift from a commensal to an opportunistic pathogen. This transition is facilitated by surface adhesins, such as clumping factor B and S. aureus surface protein G (SasG), which bind to structural proteins, including loricrin and cytokeratin, in the damaged epidermis. Protein A, another key factor, binds the Fc region of...
Antimicrobial Effectiveness01:28

Antimicrobial Effectiveness

The effectiveness of antimicrobial agents depends on various factors influencing their ability to eliminate microbial populations. Larger microbial populations require more time for complete eradication, emphasizing the importance of population size analysis when evaluating antimicrobial efficacy.Microbial resistance to antimicrobial agents varies significantly. Highly resilient microorganisms include endospores, gram-negative bacteria, and non-enveloped viruses, while prions are exceptionally...
Combined Effects of Drugs: Synergism01:27

Combined Effects of Drugs: Synergism

Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...