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Younghee Jung - One of the best experts on this subject based on the ideXlab platform.
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impact of area under the Concentration time curve to Minimum Inhibitory Concentration ratio on vancomycin treatment outcomes in methicillin resistant staphylococcus aureus bacteraemia
International Journal of Antimicrobial Agents, 2015Co-Authors: Kyoungho Song, Younghee Jung, Jeonghwan Hwang, Pyoeng Gyun Choe, Jaeyong Chung, Wan Beom Park, Kyoung Un Park, Myoungdon OhAbstract:There have been few clinical studies on the association between the vancomycin 24-h area under the Concentration–time curve (AUC24) to Minimum Inhibitory Concentration (MIC) ratio and vancomycin treatment outcomes in methicillin-resistant Staphylococcus aureus (MRSA) infections. To examine this association and to establish a suitable cut-off value for AUC24/MIC, a multicentre prospective observational study was conducted in patients with MRSA bacteraemia. Data were collected on all patients aged ≥18 years with MRSA bacteraemia treated with vancomycin for ≥72 h without dialysis. The MIC was determined by broth microdilution (BMD) and Etest. Treatment failure was defined as (i) 30-day mortality, (ii) persistent bacteraemia (≥7 days) and (iii) recurrence (≤30 days after completion of therapy). AUC24 was estimated by a Bayesian approach based on individual vancomycin Concentrations. The AUC24/MIC cut-off value for differentiating treatment success and failure was calculated by Classification and Regression Tree (CART) analysis. In total, 117 patients were enrolled, among which vancomycin treatment failure occurred in 38 (32.5%). In univariate analysis, high vancomycin MIC and low trough levels were unrelated to treatment outcomes. In the CART analysis, low vancomycin AUC24/MIC [ 400) may improve treatment outcomes.
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area under the Concentration time curve to Minimum Inhibitory Concentration ratio as a predictor of vancomycin treatment outcome in methicillin resistant staphylococcus aureus bacteraemia
International Journal of Antimicrobial Agents, 2014Co-Authors: Younghee Jung, Kyoungho Song, Pyoeng Gyun Choe, Jaeyong Chung, Wan Beom Park, Kyoung Un Park, Ji Hwan Bang, Sang Won Park, Myoungdon OhAbstract:Abstract There have been few clinical studies on the association between the 24-h area under the Concentration–time curve (AUC 24 ) to Minimum Inhibitory Concentration (MIC) ratio and vancomycin treatment outcomes in methicillin-resistant Staphylococcus aureus (MRSA) infections. Patients with MRSA bacteraemia between July 2009 and January 2012 were analysed retrospectively. All adult patients treated with vancomycin for ≥72h without dialysis were included. The MIC was determined by Etest and broth microdilution (BMD). Initial steady-state AUC 24 was estimated using a Bayesian model, and the AUC 24 /MIC cut-off value for differentiating treatment success and failure was calculated by classification and regression tree (CART) analysis. In total, 76 patients were enrolled; vancomycin treatment failure occurred in 20 patients (26.3%). Catheter-related infection was the most frequent (35.5%), followed by surgical site infection (26.3%), whilst 25 (32.9%) had complicated infections. In univariate analysis, decreased MRSA vancomycin susceptibility (MIC≥1.5mg/L) and vancomycin trough levels (15–20mg/L) were not associated with treatment outcomes. In the CART analysis, low initial vancomycin AUC 24 /MIC ( P =0.039 by Etest; 45.0% vs. 23.2%; P =0.065 by BMD). In multivariate analysis, low initial vancomycin AUC 24 /MIC was a significant risk factor for treatment failure [adjusted odds ratio (aOR)=4.39, 95% confidence interval (CI), 1.26–15.35 by Etest; aOR=3.73, 95% CI 1.10–12.61 by BMD]. In MRSA bacteraemia, a low initial vancomycin AUC 24 /MIC is an independent risk factor for vancomycin treatment failure.
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area under the Concentration time curve to Minimum Inhibitory Concentration ratio as a predictor of vancomycin treatment outcome in methicillin resistant staphylococcus aureus bacteraemia
International Journal of Antimicrobial Agents, 2014Co-Authors: Younghee Jung, Kyoungho Song, Pyoeng Gyun Choe, Jaeyong Chung, Jeong Eun Cho, Hyung Sook Kim, Nakhyun Kim, Taek Soo Kim, Wan Beom ParkAbstract:There have been few clinical studies on the association between the 24-h area under the Concentration-time curve (AUC24) to Minimum Inhibitory Concentration (MIC) ratio and vancomycin treatment outcomes in methicillin-resistant Staphylococcus aureus (MRSA) infections. Patients with MRSA bacteraemia between July 2009 and January 2012 were analysed retrospectively. All adult patients treated with vancomycin for ≥72 h without dialysis were included. The MIC was determined by Etest and broth microdilution (BMD). Initial steady-state AUC24 was estimated using a Bayesian model, and the AUC24/MIC cut-off value for differentiating treatment success and failure was calculated by classification and regression tree (CART) analysis. In total, 76 patients were enrolled; vancomycin treatment failure occurred in 20 patients (26.3%). Catheter-related infection was the most frequent (35.5%), followed by surgical site infection (26.3%), whilst 25 (32.9%) had complicated infections. In univariate analysis, decreased MRSA vancomycin susceptibility (MIC≥1.5 mg/L) and vancomycin trough levels (15-20 mg/L) were not associated with treatment outcomes. In the CART analysis, low initial vancomycin AUC24/MIC (<430 by Etest; <398.5 by BMD) was associated with a higher treatment failure rate (50.0% vs. 25.0%, P=0.039 by Etest; 45.0% vs. 23.2%; P=0.065 by BMD). In multivariate analysis, low initial vancomycin AUC24/MIC was a significant risk factor for treatment failure [adjusted odds ratio (aOR)=4.39, 95% confidence interval (CI), 1.26-15.35 by Etest; aOR=3.73, 95% CI 1.10-12.61 by BMD]. In MRSA bacteraemia, a low initial vancomycin AUC24/MIC is an independent risk factor for vancomycin treatment failure.
Kyoungho Song - One of the best experts on this subject based on the ideXlab platform.
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impact of area under the Concentration time curve to Minimum Inhibitory Concentration ratio on vancomycin treatment outcomes in methicillin resistant staphylococcus aureus bacteraemia
International Journal of Antimicrobial Agents, 2015Co-Authors: Kyoungho Song, Younghee Jung, Jeonghwan Hwang, Pyoeng Gyun Choe, Jaeyong Chung, Wan Beom Park, Kyoung Un Park, Myoungdon OhAbstract:There have been few clinical studies on the association between the vancomycin 24-h area under the Concentration–time curve (AUC24) to Minimum Inhibitory Concentration (MIC) ratio and vancomycin treatment outcomes in methicillin-resistant Staphylococcus aureus (MRSA) infections. To examine this association and to establish a suitable cut-off value for AUC24/MIC, a multicentre prospective observational study was conducted in patients with MRSA bacteraemia. Data were collected on all patients aged ≥18 years with MRSA bacteraemia treated with vancomycin for ≥72 h without dialysis. The MIC was determined by broth microdilution (BMD) and Etest. Treatment failure was defined as (i) 30-day mortality, (ii) persistent bacteraemia (≥7 days) and (iii) recurrence (≤30 days after completion of therapy). AUC24 was estimated by a Bayesian approach based on individual vancomycin Concentrations. The AUC24/MIC cut-off value for differentiating treatment success and failure was calculated by Classification and Regression Tree (CART) analysis. In total, 117 patients were enrolled, among which vancomycin treatment failure occurred in 38 (32.5%). In univariate analysis, high vancomycin MIC and low trough levels were unrelated to treatment outcomes. In the CART analysis, low vancomycin AUC24/MIC [ 400) may improve treatment outcomes.
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area under the Concentration time curve to Minimum Inhibitory Concentration ratio as a predictor of vancomycin treatment outcome in methicillin resistant staphylococcus aureus bacteraemia
International Journal of Antimicrobial Agents, 2014Co-Authors: Younghee Jung, Kyoungho Song, Pyoeng Gyun Choe, Jaeyong Chung, Wan Beom Park, Kyoung Un Park, Ji Hwan Bang, Sang Won Park, Myoungdon OhAbstract:Abstract There have been few clinical studies on the association between the 24-h area under the Concentration–time curve (AUC 24 ) to Minimum Inhibitory Concentration (MIC) ratio and vancomycin treatment outcomes in methicillin-resistant Staphylococcus aureus (MRSA) infections. Patients with MRSA bacteraemia between July 2009 and January 2012 were analysed retrospectively. All adult patients treated with vancomycin for ≥72h without dialysis were included. The MIC was determined by Etest and broth microdilution (BMD). Initial steady-state AUC 24 was estimated using a Bayesian model, and the AUC 24 /MIC cut-off value for differentiating treatment success and failure was calculated by classification and regression tree (CART) analysis. In total, 76 patients were enrolled; vancomycin treatment failure occurred in 20 patients (26.3%). Catheter-related infection was the most frequent (35.5%), followed by surgical site infection (26.3%), whilst 25 (32.9%) had complicated infections. In univariate analysis, decreased MRSA vancomycin susceptibility (MIC≥1.5mg/L) and vancomycin trough levels (15–20mg/L) were not associated with treatment outcomes. In the CART analysis, low initial vancomycin AUC 24 /MIC ( P =0.039 by Etest; 45.0% vs. 23.2%; P =0.065 by BMD). In multivariate analysis, low initial vancomycin AUC 24 /MIC was a significant risk factor for treatment failure [adjusted odds ratio (aOR)=4.39, 95% confidence interval (CI), 1.26–15.35 by Etest; aOR=3.73, 95% CI 1.10–12.61 by BMD]. In MRSA bacteraemia, a low initial vancomycin AUC 24 /MIC is an independent risk factor for vancomycin treatment failure.
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area under the Concentration time curve to Minimum Inhibitory Concentration ratio as a predictor of vancomycin treatment outcome in methicillin resistant staphylococcus aureus bacteraemia
International Journal of Antimicrobial Agents, 2014Co-Authors: Younghee Jung, Kyoungho Song, Pyoeng Gyun Choe, Jaeyong Chung, Jeong Eun Cho, Hyung Sook Kim, Nakhyun Kim, Taek Soo Kim, Wan Beom ParkAbstract:There have been few clinical studies on the association between the 24-h area under the Concentration-time curve (AUC24) to Minimum Inhibitory Concentration (MIC) ratio and vancomycin treatment outcomes in methicillin-resistant Staphylococcus aureus (MRSA) infections. Patients with MRSA bacteraemia between July 2009 and January 2012 were analysed retrospectively. All adult patients treated with vancomycin for ≥72 h without dialysis were included. The MIC was determined by Etest and broth microdilution (BMD). Initial steady-state AUC24 was estimated using a Bayesian model, and the AUC24/MIC cut-off value for differentiating treatment success and failure was calculated by classification and regression tree (CART) analysis. In total, 76 patients were enrolled; vancomycin treatment failure occurred in 20 patients (26.3%). Catheter-related infection was the most frequent (35.5%), followed by surgical site infection (26.3%), whilst 25 (32.9%) had complicated infections. In univariate analysis, decreased MRSA vancomycin susceptibility (MIC≥1.5 mg/L) and vancomycin trough levels (15-20 mg/L) were not associated with treatment outcomes. In the CART analysis, low initial vancomycin AUC24/MIC (<430 by Etest; <398.5 by BMD) was associated with a higher treatment failure rate (50.0% vs. 25.0%, P=0.039 by Etest; 45.0% vs. 23.2%; P=0.065 by BMD). In multivariate analysis, low initial vancomycin AUC24/MIC was a significant risk factor for treatment failure [adjusted odds ratio (aOR)=4.39, 95% confidence interval (CI), 1.26-15.35 by Etest; aOR=3.73, 95% CI 1.10-12.61 by BMD]. In MRSA bacteraemia, a low initial vancomycin AUC24/MIC is an independent risk factor for vancomycin treatment failure.
Annie Wongberinger - One of the best experts on this subject based on the ideXlab platform.
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comparison of method specific vancomycin Minimum Inhibitory Concentration values and their predictability for treatment outcome of meticillin resistant staphylococcus aureus mrsa infections
International Journal of Antimicrobial Agents, 2008Co-Authors: Donald I Hsu, Levita Hidayat, Ryan Quist, Janet Hindler, Asa Karlsson, Anne Yusof, Annie WongberingerAbstract:Abstract The objectives of this study were to examine the predictive value of method-specific vancomycin (VAN) Minimum Inhibitory Concentration (MIC) results on treatment outcomes of meticillin-resistant Staphylococcus aureus (MRSA) infections. VAN MIC values for MRSA strains were determined using Etest, VITEK-1, MicroScan (MScan) and broth microdilution (BMD), with additional screening for heterogeneous glycopeptide-intermediate S. aureus (hGISA) phenotype. Patients' charts were reviewed for outcome correlation. Performance characteristics of method-specific VAN MICs in predicting outcome were compared. Most (76%) of the 92 strains tested caused pneumonia or bacteraemia. The majority of strains tested (>70%) had a VAN MIC >1mg/L by Etest or MScan compared with 41% by Vitek and 7% by BMD. Agreement between test methods for high versus low MICs (>1mg/L vs. ≤1mg/L) ranged from 36% to 71%. High versus low VAN MICs by Etest differentiated response of invasive strains to VAN. Performance characteristics (sensitivity/specificity/positive predictive value/negative predictive value) were: Etest, 55/81/89/38%; and Vitek, 56/62/81/32/%, respectively. Eight strains (9%) demonstrated a hGISA phenotype; more yielded high MICs by Etest, MScan and Vitek than BMD (87%, 87% and 75% vs. 50%). In conclusion, VAN MIC testing methods produce highly variable results. The Etest method appears to be relatively more reliable in predicting treatment response and yielded higher MICs for strains with a hGISA phenotype.
Myoungdon Oh - One of the best experts on this subject based on the ideXlab platform.
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impact of area under the Concentration time curve to Minimum Inhibitory Concentration ratio on vancomycin treatment outcomes in methicillin resistant staphylococcus aureus bacteraemia
International Journal of Antimicrobial Agents, 2015Co-Authors: Kyoungho Song, Younghee Jung, Jeonghwan Hwang, Pyoeng Gyun Choe, Jaeyong Chung, Wan Beom Park, Kyoung Un Park, Myoungdon OhAbstract:There have been few clinical studies on the association between the vancomycin 24-h area under the Concentration–time curve (AUC24) to Minimum Inhibitory Concentration (MIC) ratio and vancomycin treatment outcomes in methicillin-resistant Staphylococcus aureus (MRSA) infections. To examine this association and to establish a suitable cut-off value for AUC24/MIC, a multicentre prospective observational study was conducted in patients with MRSA bacteraemia. Data were collected on all patients aged ≥18 years with MRSA bacteraemia treated with vancomycin for ≥72 h without dialysis. The MIC was determined by broth microdilution (BMD) and Etest. Treatment failure was defined as (i) 30-day mortality, (ii) persistent bacteraemia (≥7 days) and (iii) recurrence (≤30 days after completion of therapy). AUC24 was estimated by a Bayesian approach based on individual vancomycin Concentrations. The AUC24/MIC cut-off value for differentiating treatment success and failure was calculated by Classification and Regression Tree (CART) analysis. In total, 117 patients were enrolled, among which vancomycin treatment failure occurred in 38 (32.5%). In univariate analysis, high vancomycin MIC and low trough levels were unrelated to treatment outcomes. In the CART analysis, low vancomycin AUC24/MIC [ 400) may improve treatment outcomes.
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area under the Concentration time curve to Minimum Inhibitory Concentration ratio as a predictor of vancomycin treatment outcome in methicillin resistant staphylococcus aureus bacteraemia
International Journal of Antimicrobial Agents, 2014Co-Authors: Younghee Jung, Kyoungho Song, Pyoeng Gyun Choe, Jaeyong Chung, Wan Beom Park, Kyoung Un Park, Ji Hwan Bang, Sang Won Park, Myoungdon OhAbstract:Abstract There have been few clinical studies on the association between the 24-h area under the Concentration–time curve (AUC 24 ) to Minimum Inhibitory Concentration (MIC) ratio and vancomycin treatment outcomes in methicillin-resistant Staphylococcus aureus (MRSA) infections. Patients with MRSA bacteraemia between July 2009 and January 2012 were analysed retrospectively. All adult patients treated with vancomycin for ≥72h without dialysis were included. The MIC was determined by Etest and broth microdilution (BMD). Initial steady-state AUC 24 was estimated using a Bayesian model, and the AUC 24 /MIC cut-off value for differentiating treatment success and failure was calculated by classification and regression tree (CART) analysis. In total, 76 patients were enrolled; vancomycin treatment failure occurred in 20 patients (26.3%). Catheter-related infection was the most frequent (35.5%), followed by surgical site infection (26.3%), whilst 25 (32.9%) had complicated infections. In univariate analysis, decreased MRSA vancomycin susceptibility (MIC≥1.5mg/L) and vancomycin trough levels (15–20mg/L) were not associated with treatment outcomes. In the CART analysis, low initial vancomycin AUC 24 /MIC ( P =0.039 by Etest; 45.0% vs. 23.2%; P =0.065 by BMD). In multivariate analysis, low initial vancomycin AUC 24 /MIC was a significant risk factor for treatment failure [adjusted odds ratio (aOR)=4.39, 95% confidence interval (CI), 1.26–15.35 by Etest; aOR=3.73, 95% CI 1.10–12.61 by BMD]. In MRSA bacteraemia, a low initial vancomycin AUC 24 /MIC is an independent risk factor for vancomycin treatment failure.
Wan Beom Park - One of the best experts on this subject based on the ideXlab platform.
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impact of area under the Concentration time curve to Minimum Inhibitory Concentration ratio on vancomycin treatment outcomes in methicillin resistant staphylococcus aureus bacteraemia
International Journal of Antimicrobial Agents, 2015Co-Authors: Kyoungho Song, Younghee Jung, Jeonghwan Hwang, Pyoeng Gyun Choe, Jaeyong Chung, Wan Beom Park, Kyoung Un Park, Myoungdon OhAbstract:There have been few clinical studies on the association between the vancomycin 24-h area under the Concentration–time curve (AUC24) to Minimum Inhibitory Concentration (MIC) ratio and vancomycin treatment outcomes in methicillin-resistant Staphylococcus aureus (MRSA) infections. To examine this association and to establish a suitable cut-off value for AUC24/MIC, a multicentre prospective observational study was conducted in patients with MRSA bacteraemia. Data were collected on all patients aged ≥18 years with MRSA bacteraemia treated with vancomycin for ≥72 h without dialysis. The MIC was determined by broth microdilution (BMD) and Etest. Treatment failure was defined as (i) 30-day mortality, (ii) persistent bacteraemia (≥7 days) and (iii) recurrence (≤30 days after completion of therapy). AUC24 was estimated by a Bayesian approach based on individual vancomycin Concentrations. The AUC24/MIC cut-off value for differentiating treatment success and failure was calculated by Classification and Regression Tree (CART) analysis. In total, 117 patients were enrolled, among which vancomycin treatment failure occurred in 38 (32.5%). In univariate analysis, high vancomycin MIC and low trough levels were unrelated to treatment outcomes. In the CART analysis, low vancomycin AUC24/MIC [ 400) may improve treatment outcomes.
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area under the Concentration time curve to Minimum Inhibitory Concentration ratio as a predictor of vancomycin treatment outcome in methicillin resistant staphylococcus aureus bacteraemia
International Journal of Antimicrobial Agents, 2014Co-Authors: Younghee Jung, Kyoungho Song, Pyoeng Gyun Choe, Jaeyong Chung, Wan Beom Park, Kyoung Un Park, Ji Hwan Bang, Sang Won Park, Myoungdon OhAbstract:Abstract There have been few clinical studies on the association between the 24-h area under the Concentration–time curve (AUC 24 ) to Minimum Inhibitory Concentration (MIC) ratio and vancomycin treatment outcomes in methicillin-resistant Staphylococcus aureus (MRSA) infections. Patients with MRSA bacteraemia between July 2009 and January 2012 were analysed retrospectively. All adult patients treated with vancomycin for ≥72h without dialysis were included. The MIC was determined by Etest and broth microdilution (BMD). Initial steady-state AUC 24 was estimated using a Bayesian model, and the AUC 24 /MIC cut-off value for differentiating treatment success and failure was calculated by classification and regression tree (CART) analysis. In total, 76 patients were enrolled; vancomycin treatment failure occurred in 20 patients (26.3%). Catheter-related infection was the most frequent (35.5%), followed by surgical site infection (26.3%), whilst 25 (32.9%) had complicated infections. In univariate analysis, decreased MRSA vancomycin susceptibility (MIC≥1.5mg/L) and vancomycin trough levels (15–20mg/L) were not associated with treatment outcomes. In the CART analysis, low initial vancomycin AUC 24 /MIC ( P =0.039 by Etest; 45.0% vs. 23.2%; P =0.065 by BMD). In multivariate analysis, low initial vancomycin AUC 24 /MIC was a significant risk factor for treatment failure [adjusted odds ratio (aOR)=4.39, 95% confidence interval (CI), 1.26–15.35 by Etest; aOR=3.73, 95% CI 1.10–12.61 by BMD]. In MRSA bacteraemia, a low initial vancomycin AUC 24 /MIC is an independent risk factor for vancomycin treatment failure.
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area under the Concentration time curve to Minimum Inhibitory Concentration ratio as a predictor of vancomycin treatment outcome in methicillin resistant staphylococcus aureus bacteraemia
International Journal of Antimicrobial Agents, 2014Co-Authors: Younghee Jung, Kyoungho Song, Pyoeng Gyun Choe, Jaeyong Chung, Jeong Eun Cho, Hyung Sook Kim, Nakhyun Kim, Taek Soo Kim, Wan Beom ParkAbstract:There have been few clinical studies on the association between the 24-h area under the Concentration-time curve (AUC24) to Minimum Inhibitory Concentration (MIC) ratio and vancomycin treatment outcomes in methicillin-resistant Staphylococcus aureus (MRSA) infections. Patients with MRSA bacteraemia between July 2009 and January 2012 were analysed retrospectively. All adult patients treated with vancomycin for ≥72 h without dialysis were included. The MIC was determined by Etest and broth microdilution (BMD). Initial steady-state AUC24 was estimated using a Bayesian model, and the AUC24/MIC cut-off value for differentiating treatment success and failure was calculated by classification and regression tree (CART) analysis. In total, 76 patients were enrolled; vancomycin treatment failure occurred in 20 patients (26.3%). Catheter-related infection was the most frequent (35.5%), followed by surgical site infection (26.3%), whilst 25 (32.9%) had complicated infections. In univariate analysis, decreased MRSA vancomycin susceptibility (MIC≥1.5 mg/L) and vancomycin trough levels (15-20 mg/L) were not associated with treatment outcomes. In the CART analysis, low initial vancomycin AUC24/MIC (<430 by Etest; <398.5 by BMD) was associated with a higher treatment failure rate (50.0% vs. 25.0%, P=0.039 by Etest; 45.0% vs. 23.2%; P=0.065 by BMD). In multivariate analysis, low initial vancomycin AUC24/MIC was a significant risk factor for treatment failure [adjusted odds ratio (aOR)=4.39, 95% confidence interval (CI), 1.26-15.35 by Etest; aOR=3.73, 95% CI 1.10-12.61 by BMD]. In MRSA bacteraemia, a low initial vancomycin AUC24/MIC is an independent risk factor for vancomycin treatment failure.
