{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:29:49Z","timestamp":1777922989656,"version":"3.51.4"},"reference-count":47,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,3,1]],"date-time":"2020-03-01T00:00:00Z","timestamp":1583020800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2020,3]]},"abstract":"\n Aims:<\/jats:title>\n \n Heterogeneous vancomycin-intermediate\n Staphylococcus aureus<\/jats:italic>\n (<\/jats:bold>\n hVISA) could be misinterpreted as \u201csusceptible\u201d with routine susceptibility testing procedures, and the subpopulations with reduced susceptibility to glycopeptides can lead to therapeutic failure. The aim of this study was to evaluate the presence of VISA and hVISA strains among stocked bloodstream methicillin-resistant\n S. aureus<\/jats:italic>\n (MRSA) isolates of 14 years.\n <\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n A total of 127 nonduplicate MRSA strains isolated from blood cultures between 2001 and 2014 were investigated. Glycopeptide minimum inhibitory concentration values were detected by microbroth dilution method. Susceptibilities to other antimicrobials were determined by the disk diffusion method and interpreted according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. Macrogradient test (MGT) and modified population analysis profile-area under the curve (modified PAP-AUC) methods were used to detect VISA and hVISA. Staphylococcal Cassette Chromosome\n mec<\/jats:italic>\n (SCC\n mec<\/jats:italic>\n ),\n agr<\/jats:italic>\n , and toxin gene typing were done by polymerase chain reaction. Genetic relatedness of the strains were evaluated by pulsed-field gel electrophoresis (PFGE).\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n All isolates were susceptible to glycopeptides, linezolid, and quinupristin-dalfopristin. All were resistant to tetracycline, 96% were resistant to aminoglycosides, fluoroquinolones, and rifampin. Only 58.3% of the isolates were susceptible to ceftaroline. Six isolates were suspected as hVISA by the MGT, but none could be confirmed by the modified PAP-AUC analysis. All isolates carried type-III SCC\n mec<\/jats:italic>\n ,\n sea<\/jats:italic>\n was the most prevalent (96.9%) enterotoxin gene and\n agr<\/jats:italic>\n group I locus was predominant (93.7%). PFGE analysis revealed four main and four unique patterns.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n No hVISA or VISA were detected. The resistance rate to ceftaroline seems remarkable due to its recent entry into the market in Turkey.<\/jats:p>\n <\/jats:sec>","DOI":"10.1089\/mdr.2019.0178","type":"journal-article","created":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T11:44:06Z","timestamp":1569239046000},"page":"238-244","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Evaluation of the Presence and Characterization of Vancomycin-Intermediate and Heterogeneous Vancomycin-Intermediate Level Resistance Among Bloodstream Isolates of Methicillin-Resistant\n Staphylococcus aureus<\/i>"],"prefix":"10.1177","volume":"26","author":[{"given":"Busra Betul","family":"Ozmen Capin","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alper","family":"Tekeli","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeynep Ceren","family":"Karahan","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey."},{"name":"Central Microbiology Laboratory, Ibn-i Sina Hospital, Ankara, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,3,5]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"European Centre for Disease Prevention and Control (ECDC). 2017. 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