The document discusses appropriate antibiotic treatment for a patient with deep soft tissue and bone cultures growing methicillin-sensitive Staphylococcus aureus and Group B Streptococcus. It recommends an anti-staphylococcal and streptococcal antibiotic such as cephalexin. It also cautions monitoring vancomycin minimum inhibitory concentrations to watch for rising resistance and considers alternatives if the MIC is greater than 1μg/ml.
Vancomycin MIC on the Move 1 A single-center retrospective analysis of susceptibility test results for 6003 S aureus isolates from 2000 to 2004. Vancomycin minimum inhibitory concentration (MIC) was determined by broth dilution as recommended by the Clinical and Laboratory Standards Institute. The percentage of MRSA isolates with MIC >1 was higher than the percentage of methicillin-susceptible S aureus (MSSA) isolates over the 5-year period (54.9% for MRSA vs 31% for MSSA). The prevalence of methicillin resistance in S aureus isolates increased from 24.9% in 2000 to 45.1% in 2004. Only one isolate, in 2001, was reported to be vancomycin-intermediate S aureus (MIC 8 µ g/mL); no vancomycin-resistant S aureus isolates were detected. Reference 1. Wang G, Hindler JF, Ward KW, Bruckner DA. Increased vancomycin MICs for Staphylococcus aureus clinical isolates from a university hospital during a 5-year period. J Clin Microbiol . 2006;44:3883-3886.
