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You searched for +publisher:"University of Kansas" +contributor:("El Atrouni, Wissam"). One record found.

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University of Kansas

1. Britt, Nicholas. The relationship between vancomycin tolerance and clinical outcomes in patients with Staphylococcus aureus bacteremia.

Degree: MS, Clinical Research, 5, University of Kansas

Background: Treatment failure is increasingly common in Staphylococcus aureus bacteremia (SAB). Vancomycin tolerance may be playing a role in clinical outcomes in SAB that has yet to be fully explored. Methods: This was a single-center retrospective cohort study of 166 patients (September 2012 - January 2014) evaluating the relationship between vancomycin tolerance and clinical failure in SAB. Vancomycin minimum inhibitory concentration (MIC) was determined by broth microdilution and Etest. Vancomycin tolerance was defined as a vancomycin minimum bactericidal concentration (MBC)/MIC greater than or equal to 32. Univariable and multivariable analyses were conducted to determine the relationship between vancomycin tolerance and clinical failure after adjusting for other factors. Results: Of the 166 patients evaluated, 26.5% had vancomycin tolerant clinical isolates. Tolerance to vancomycin was more common in methicillin-susceptible S. aureus bacteremia (MSSA-B) than methicillin-resistant S. aureus bacteremia (MRSA-B; n=29/101 [28.7%] vs. n=15/65 [23.1%]), although not significantly (P=0.422). Clinical failure was frequently observed (50% overall). Elevated vancomycin MIC by Etest (greater than or equal to 1.5 mcg/mL) was not associated with clinical failure (P=0.50). Vancomycin tolerance was significantly associated with SAB clinical failure in univariable analysis (P=0.014). This relationship persisted even when adjusting for other factors in multivariable analysis (adjusted odds ratio [AOR], 2.70; 95% confidence interval [CI], 1.27-5.70; P=0.010). Conclusions: Vancomycin tolerance is a clinically significant predictor of clinical failure in SAB independent of methicillin susceptibility and antibiotic choice. Future research is needed to determine optimal treatment of vancomycin tolerant SAB. Advisors/Committee Members: Shireman, Theresa I (advisor), El Atrouni, Wissam (cmtemember), Steed, Molly E (cmtemember).

Subjects/Keywords: Microbiology; Medicine; antibiotic resistance; antibiotic tolerance; Staphylococcus aureus; vancomycin

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Britt, N. (5). The relationship between vancomycin tolerance and clinical outcomes in patients with Staphylococcus aureus bacteremia. (Masters Thesis). University of Kansas. Retrieved from http://hdl.handle.net/1808/22541

Chicago Manual of Style (16th Edition):

Britt, Nicholas. “The relationship between vancomycin tolerance and clinical outcomes in patients with Staphylococcus aureus bacteremia.” 5. Masters Thesis, University of Kansas. Accessed July 21, 2019. http://hdl.handle.net/1808/22541.

MLA Handbook (7th Edition):

Britt, Nicholas. “The relationship between vancomycin tolerance and clinical outcomes in patients with Staphylococcus aureus bacteremia.” 5. Web. 21 Jul 2019.

Vancouver:

Britt N. The relationship between vancomycin tolerance and clinical outcomes in patients with Staphylococcus aureus bacteremia. [Internet] [Masters thesis]. University of Kansas; 5. [cited 2019 Jul 21]. Available from: http://hdl.handle.net/1808/22541.

Council of Science Editors:

Britt N. The relationship between vancomycin tolerance and clinical outcomes in patients with Staphylococcus aureus bacteremia. [Masters Thesis]. University of Kansas; 5. Available from: http://hdl.handle.net/1808/22541

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