Clinical features associated with bacteremia due to heterogeneous vancomycin-intermediate Staphylococcus aureus

We assessed all episodes of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia at our hospital during a 12-month period (n = 53) and compared those due to heterogeneous vancomycin-intermediate S. aureus (hVISA; n=5, 9.4%) with those due to vancomycin-susceptible MRSA (n = 48). Patients with hVISA bacteremia were more likely to have high bacterial load infections (P = .001), vancomycin treatment failure (persistent fever and bacteremia for >7 days after the start of therapy; P < .001), and initially low serum vancomycin levels (P = .006). These clinical markers of hVISA bacteremia may help focus diagnostic efforts and treatment.