{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T19:39:41Z","timestamp":1765827581187,"version":"3.41.2"},"reference-count":41,"publisher":"American Society for Microbiology","issue":"7","license":[{"start":{"date-parts":[[2017,7,1]],"date-time":"2017-07-01T00:00:00Z","timestamp":1498867200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100000060","name":"HHS | NIH | National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K08AI090013"],"award-info":[{"award-number":["K08AI090013"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Methicillin-susceptible\n            <jats:named-content content-type=\"genus-species\">Staphylococcus aureus<\/jats:named-content>\n            (MSSA) bloodstream infections (BSIs) often lead to severe complications despite the availability of effective antibiotics. It remains unclear whether elevated vancomycin MICs are associated with worse outcomes. We conducted a 2-year retrospective cohort study (\n            <jats:italic>n<\/jats:italic>\n            = 252) of patients with MSSA BSIs at a tertiary care hospital. We defined reduced vancomycin susceptibility (RVS) as a Microscan MIC of 2 mg\/liter. All strains were genotyped (\n            <jats:italic>spa<\/jats:italic>\n            ) and assessed for\n            <jats:italic>agr<\/jats:italic>\n            functionality. Multivariable logistic regression models were used to examine the impact of RVS phenotype and strain genotype on 30-day all-cause mortality and complicated bacteremia (metastatic spread, endovascular infection, or duration \u22653 days). One-third of patients (84\/252) were infected with RVS isolates. RVS Infections were more frequently associated with metastatic or embolic sites of infection (36% versus 17%,\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001), and endovascular infection (26% versus 12%,\n            <jats:italic>P<\/jats:italic>\n            = 0.004). These infections occurred more often in patients with fewer underlying comorbidities (Charlson comorbidity index of \u22653 [73% versus 88%,\n            <jats:italic>P<\/jats:italic>\n            = 0.002]). Genotyping identified 127\n            <jats:italic>spa<\/jats:italic>\n            -types and 14 Spa-clonal complexes (Spa-CCs). Spa-CC002 and Spa-CC008 were more likely to exhibit the RVS phenotype versus other Spa-CCs (OR = 2.2,\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.01). The RVS phenotype was not significantly associated with 30-day mortality; however, it was associated with complicated bacteremia (adjusted odds ratio of 2.35 [range, 1.26 to 4.37];\n            <jats:italic>P<\/jats:italic>\n            = 0.007) in adjusted analyses. The association of RVS strains with complicated infection and fewer underlying comorbidities suggests the phenotype as a potential marker of strain virulence in MSSA BSIs. The RVS phenotype itself was not a significant predictor of mortality in this patient cohort. Further studies are necessary to explore this host-pathogen relationship.\n          <\/jats:p>","DOI":"10.1128\/aac.00316-17","type":"journal-article","created":{"date-parts":[[2017,5,16]],"date-time":"2017-05-16T00:50:18Z","timestamp":1494895818000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":18,"title":["Reduced Vancomycin Susceptibility of Methicillin-Susceptible Staphylococcus aureus Has No Significant Impact on Mortality but Results in an Increase in Complicated Infection"],"prefix":"10.1128","volume":"61","author":[{"given":"Sean B.","family":"Sullivan","sequence":"first","affiliation":[{"name":"Department of Medicine, Columbia University Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eloise D.","family":"Austin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephania","family":"Stump","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barun","family":"Mathema","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Whittier","sequence":"additional","affiliation":[{"name":"Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franklin D.","family":"Lowy","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Medical Center, New York, New York, USA"},{"name":"Department of Pathology and Cell Biology, 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