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Antimicrob. Agents Chemother. doi:10.1128/AAC.01009-08
Copyright (c) 2008, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Impact of inoculum and heterogeneous vancomycin intermediate Staphylococcus aureus (hVISA) on vancomycin activity and emergence of VISA in an in vitro pharmacodynamic model

Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, and School of Medicine, Wayne State University, Detroit, MI USA, 48201; Detroit Receiving Hospital, Detroit, MI, USA, 48201; John D. Dingell Department of Veteran's Affairs Medical Center, Detroit, MI USA 48201; University of Wisconsin School of Pharmacy, Madison, WI 53705

	Abstract

The activity of vancomycin against hVISA and non-hVISA isolates was reduced in the presence of a high inoculum (10⁸ CFU/ml) using an in vitro pharmacodynamic model. A high bacterial load of > 10⁵ CFU/mL persisted in all strains with doses up to 5 g every 12 h against high inoculum. No change in vancomycin MIC was detected in any isolate at moderate inoculum (10⁶ CFU/ml) and bactericidal activity occurred only in the non-hVISA (T₉₉ 7.5 h; p=0.001)