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Journal of Clinical Microbiology, December 2001, p. 4445-4451, Vol. 39, No. 12
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.12.4445-4451.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Nationwide Survey Shows that Methicillin-Resistant Staphylococcus aureus Strains Heterogeneously and Intermediately Resistant to Vancomycin Are Not Disseminated throughout Japanese Hospitals

Yasuyoshi Ike,1,2,* Yoshichika Arakawa,3 Xinghua Ma,1 Kenichi Tatewaki,4 Mitsuaki Nagasawa,5 Haruyoshi Tomita,1 Koichi Tanimoto,1 and Shuhei Fujimoto1

Department of Microbiology1 and Laboratory of Bacterial Drug Resistance,2 Gunma University School of Medicine, Maebashi, Gunma 371-8511, Department of Bacterial and Blood Products, National Institute of Infectious Diseases, Musashi-Murayama, Tokyo 208-0011,3 Department of Central Clinical Laboratory, Shiga University of Medical Science, Otsu, Shiga 520-2192,4 and Department of Laboratory Medicine, National Defense Medical College, Tokorozawa, Saitama 359-8513,5 Japan

Received 29 May 2001/Returned for modification 6 August 2001/Accepted 17 September 2001

A total of 6,625 methicillin-resistant Staphylococcus aureus (MRSA) clinical isolates obtained from 278 hospitals throughout Japan were obtained between November and December 1997 and were examined for their sensitivities to vancomycin using Mueller Hinton (MH), brain heart infusion (BHI), agar plates, or the broth microdilution method. A concentrated inoculum of an MRSA strain or the use of highly enriched medium, such as BHI medium, allows an individual cell to grow on agar plates containing a vancomycin concentration greater than the MIC for the parent strain. However, cells of the colonies which grew on BHI agar plates containing the higher vancomycin concentrations did not acquire a level of vancomycin resistance greater than that of the parent strain and were not subpopulations of heterogeneously vancomycin-resistant MRSA. There was no significance in the fact that these colonies grew on the higher concentration of vancomycin: none showed stable resistance to vancomycin at a concentration above the MIC for the parent strain, and no cell from these colonies showed a relationship between the MIC and the ability of these colonies to grow on higher concentrations of vancomycin. The vancomycin MIC was not above 2 µg/ml for any of the cells originating from these colonies. No Mu3-type heterogeneously resistant MRSA strains, which constitutively produce subpopulations from MRSA clinical isolates with intermediate vancomycin resistance at a high frequency, were detected. There was a unipolar distribution of the MICs ranging from 0.25 to 2 µg of vancomycin/ml among the 6,625 MRSA clinical isolates, indicating that there was no Mu50-type intermediately vancomycin-resistant MRSA (MIC, 8 µg/ml by National Committee for Clinical Laboratory Standards criteria) among the clinical isolates, and there was no evidence of dissemination of Mu3-type MRSA heteroresistant to vancomycin.

* Corresponding author. Mailing address: Department of Microbiology, Gunma University School of Medicine, Showa-machi 3-39-22, Maebashi, Gunma 371-8511, Japan. Phone: 81-27-220-7990. Fax: 81-27-220-7996. E-mail: yasuike{at}med.gunma-u.ac.jp.

Journal of Clinical Microbiology, December 2001, p. 4445-4451, Vol. 39, No. 12
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.12.4445-4451.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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