Performance of vancomycin and teicoplanin disk diffusion test in isogenic vancomycin non-susceptible Staphylococcus aureus

Introduction: Detection of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) is currently problematic. Although the population analysis profile with area under the curve (PAP-AUC) is the gold standard for detecting hVISA strains, this method is time consuming. This study aimed to i...

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Main Authors: Sujintana Wongthong, Karnjana Dutchanutouch, Viladda Namsaengkang, Aroonwadee Chanawong, Chotechana Wilailuckana, Aroonlug Lulitanond
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2015-02-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/5059
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author Sujintana Wongthong
Karnjana Dutchanutouch
Viladda Namsaengkang
Aroonwadee Chanawong
Chotechana Wilailuckana
Aroonlug Lulitanond
author_facet Sujintana Wongthong
Karnjana Dutchanutouch
Viladda Namsaengkang
Aroonwadee Chanawong
Chotechana Wilailuckana
Aroonlug Lulitanond
author_sort Sujintana Wongthong
collection DOAJ
description Introduction: Detection of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) is currently problematic. Although the population analysis profile with area under the curve (PAP-AUC) is the gold standard for detecting hVISA strains, this method is time consuming. This study aimed to induce vancomycin non-susceptible Staphylococcus aureus isolates in methicillin-resistant S. aureus (MRSA) and to determine the performance of the vancomycin and teicoplanin disk diffusion test for screening of induced and natural vancomycin non-susceptible isolates. Methodology: Vancomycin resistance was induced in vitro in methicillin-resistant S. aureus by serial passage in media with increasing vancomycin concentrations. All test isolates were confirmed for their susceptibility to vancomycin by using a PAP-AUC method. The performance of the vancomycin and teicoplanin disk diffusion test for detecting both induced and natural hVISA/VISA isolates was analyzed using the MedCal program version 10.2.0. Results: The induction test revealed that 42 of 78 MRSA isolates (53.8%) became hVISA and/or VISA. Using 10, 15, 20, 30 µg vancomycin disks and a 30 µg teicoplanin disk, the highest performance (88.9%) for hVISA/VISA detection (71.1%, sensitivity, 100% specificity, 100% positive predictive value, and 75% negative predictive value) was obtained when a 20 µg vancomycin disk was used at 1.0 McFarland inoculum for a 24-hour incubation. Conclusions: The results indicated that using a 20 µg vancomycin disk and bacterial inoculum of 1.0 McFarland is simple to perform and provides a primary result for hVISA/VISA screening within 24 hours.
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spelling doaj-art-e63a5d0fe2dc49cba79a3d9ee3b0ca972025-08-20T02:16:06ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802015-02-0190210.3855/jidc.5059Performance of vancomycin and teicoplanin disk diffusion test in isogenic vancomycin non-susceptible Staphylococcus aureusSujintana Wongthong0Karnjana Dutchanutouch1Viladda Namsaengkang2Aroonwadee Chanawong3Chotechana Wilailuckana4Aroonlug Lulitanond5Graduate School, Khon Kaen University, Khon Kaen, ThailandFaculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, ThailandFaculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, ThailandCentre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, ThailandCentre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, ThailandCentre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, ThailandIntroduction: Detection of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) is currently problematic. Although the population analysis profile with area under the curve (PAP-AUC) is the gold standard for detecting hVISA strains, this method is time consuming. This study aimed to induce vancomycin non-susceptible Staphylococcus aureus isolates in methicillin-resistant S. aureus (MRSA) and to determine the performance of the vancomycin and teicoplanin disk diffusion test for screening of induced and natural vancomycin non-susceptible isolates. Methodology: Vancomycin resistance was induced in vitro in methicillin-resistant S. aureus by serial passage in media with increasing vancomycin concentrations. All test isolates were confirmed for their susceptibility to vancomycin by using a PAP-AUC method. The performance of the vancomycin and teicoplanin disk diffusion test for detecting both induced and natural hVISA/VISA isolates was analyzed using the MedCal program version 10.2.0. Results: The induction test revealed that 42 of 78 MRSA isolates (53.8%) became hVISA and/or VISA. Using 10, 15, 20, 30 µg vancomycin disks and a 30 µg teicoplanin disk, the highest performance (88.9%) for hVISA/VISA detection (71.1%, sensitivity, 100% specificity, 100% positive predictive value, and 75% negative predictive value) was obtained when a 20 µg vancomycin disk was used at 1.0 McFarland inoculum for a 24-hour incubation. Conclusions: The results indicated that using a 20 µg vancomycin disk and bacterial inoculum of 1.0 McFarland is simple to perform and provides a primary result for hVISA/VISA screening within 24 hours. https://jidc.org/index.php/journal/article/view/5059Staphylococcus aureusvancomycin resistanceteicoplanininductionPAP-AUC
spellingShingle Sujintana Wongthong
Karnjana Dutchanutouch
Viladda Namsaengkang
Aroonwadee Chanawong
Chotechana Wilailuckana
Aroonlug Lulitanond
Performance of vancomycin and teicoplanin disk diffusion test in isogenic vancomycin non-susceptible Staphylococcus aureus
Journal of Infection in Developing Countries
Staphylococcus aureus
vancomycin resistance
teicoplanin
induction
PAP-AUC
title Performance of vancomycin and teicoplanin disk diffusion test in isogenic vancomycin non-susceptible Staphylococcus aureus
title_full Performance of vancomycin and teicoplanin disk diffusion test in isogenic vancomycin non-susceptible Staphylococcus aureus
title_fullStr Performance of vancomycin and teicoplanin disk diffusion test in isogenic vancomycin non-susceptible Staphylococcus aureus
title_full_unstemmed Performance of vancomycin and teicoplanin disk diffusion test in isogenic vancomycin non-susceptible Staphylococcus aureus
title_short Performance of vancomycin and teicoplanin disk diffusion test in isogenic vancomycin non-susceptible Staphylococcus aureus
title_sort performance of vancomycin and teicoplanin disk diffusion test in isogenic vancomycin non susceptible staphylococcus aureus
topic Staphylococcus aureus
vancomycin resistance
teicoplanin
induction
PAP-AUC
url https://jidc.org/index.php/journal/article/view/5059
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