Vol.70 No.3 May 2022
Assessment of vancomycin trough concentration and minimum inhibitory concentration on vancomycin treatment for catheter-associated bloodstream infections caused by methicillin-resistant coagulase-negative Staphylococci
1)Department of Pharmacy, Tenshi Hospital, N12-E3-1-1 Higashi-ku, Sapporo, Hokkaido, Japan
2)Faculty of Pharmacy, Hokkaido University of Science
3)Department of Surgery, Tenshi Hospital
Abstract
Methicillin-resistant coagulase negative Staphylococci (MRCNS) infections are one of the most common causes of healthcare-associated infections. Although vancomycin (VCM) is the first-line drug for treatment, few reports have investigated the therapeutic effect of VCM in terms of the VCM minimum inhibitory concentration (MIC) for MRCNS and the target trough blood concentration of VCM. This retrospective study analyzed the patient backgrounds and therapeutic effectiveness of VCM treatment performed for catheter-related bloodstream infections in which MRCNS was detected in blood cultures, dividing the patients into 2 groups according to therapeutic effectiveness. Thirty-five patients were examined: 20 in the therapeutic effective group and 15 in the therapeutic ineffective group. The VCM trough concentration was significantly higher in the therapeutic effective group (median 15.2 μg/mL vs. 12.9 μg/mL, p=0.042). The cutoff value for a therapeutically effective VCM trough concentration was calculated to be 10.2 μg/mL using an ROC analysis. A logistic regression analysis showed that a "steady-state trough blood concentration of VCM" and "central venous catheter removal" were statistically significant independent factors of treatment effectiveness (p=0.043 and p=0.013, respectively). However, no significant relationship between the VCM MIC for MRCNS and therapeutic effectiveness was seen. Thus, this study suggested 2 factors relevant to the treatment of catheter-related bloodstream infections with MRCNS.
Key word
vancomycin, MRCNS, CRBSI, trough concentration
Received
October 6, 2021
Accepted
January 14, 2022
Jpn. J. Chemother. 70 (3): 317-325, 2022
