Abid Mahmood, Tariq Butt, Muhammad Usman.
A study on MRSA isolates to detect reduced susceptibility to Vancomycin: a preliminary report.
Infect Dis J Jan ;16(4):102-4.

Objective: To determine vancomycin susceptibility and detection of any Vancomycin Intermediate Staph. Aureus (VISA) among MRSA isolates. Design: A descriptive study Place and duration of study: The study was conducted at the Armed Forces Institute of Pathology, Rawalpindi during 2003-2004 Patients and methods: All non-duplicate MRSA isolates from clinical specimens including pus, tissue, body fluids, blood, sputum, urine, catheter tips and tubes were included in the study. Methicillin resistance was tested by modified Kirby-Bauer disk diffusion technique and oxacillin screen agar (Remel, USA) test according to NCCLS guidelines. In addition to the disc diffusion test for vancomycin susceptibility testing, the isolates were studied by the three CDC- recommended methods of VISA detection i.e. Vancomycin screen agar, MICs by broth dilution and MICs by E-test. Results: All the isolates were susceptible to vancomycin by disk diffusion technique. None of the isolates was positive for vancomycin agar screen test. All the isolates were susceptible by broth microdilution and Etest (MIC < 4 µg/ml). Essential agreement between E-test and broth microdilution methods was 92%. Conclusion: This study indicates that no vancomycin reduced susceptibility exists amongst the studied isolates.

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