Impact of reduced vancomycin susceptibility on the therapeutic outcome of MRSA bloodstream infections

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to determine whether clinical outcome of patients with methicillin-resistant <it>Staphylococcus aureus </it>(MRSA) bacteraemia was correlated with vancomycin susceptibility of the corresponding strains.</p> <p>Methods</p> <p>A retrospective study on MRSA bacteraemia was performed at a teaching hospital between January 1998 and October 2005 by linking vancomycin susceptibility profiles of patients' isolates with hospitalization data.</p> <p>Results</p> <p>A total of 20 out of 209 MRSA bacteraemia patients were treated with vancomycin for at least 5 days with adequate trough levels, and fulfilled the study's inclusion and exclusion criteria. Twenty-two <it>S. aureus </it>isolates from these patients' blood cultures were identified as MRSA, including two <it>hetero</it>-VISA from separate patients and two VISA with vancomycin MIC of 4 mg/L from one patient. Between patients who showed 'good' vancomycin response and patients who did not, there was a significant difference (p < 0.01) in their corresponding MRSAs' vancomycin susceptibility expressed by 'area under curve' (AUC) of population analysis. Significant correlations were found between AUC and initial vancomycin therapeutic response parameters of 'days till afebrile' (<it>r </it>= 0.828, p < 0.01) and 'days till CRP ≦ 30% of maximum' (<it>r </it>= 0.627, p < 0.01)</p> <p>Conclusion</p> <p>Our study results caution healthcare personnel that early consideration should be given to cases with a poor vancomycin treatment response that could signify the involvement of MRSA with reduced susceptibility to vancomycin.</p

First results on the cluster galaxy population from the Subaru Hyper Suprime-Cam survey. II. Faint end color-magnitude diagrams and radial profiles of red and blue galaxies at 0.1<z<1.10.1<z<1.1

We present a statistical study of the redshift evolution of the cluster galaxy population over a wide redshift range from 0.1 to 1.1, using $\sim 1900$ optically-selected CAMIRA clusters from $\sim 232$~deg$^2$ of the Hyper Suprime-Cam (HSC) Wide S16A data. Our stacking technique with a statistical background subtraction reveals color-magnitude diagrams of red-sequence and blue cluster galaxies down to faint magnitudes of $m_z\sim 24$. We find that the linear relation of red-sequence galaxies in the color-magnitude diagram extends down to the faintest magnitudes we explore with a small intrinsic scatter $\sigma_{\rm int}(g-r)<0.1$. The scatter does not evolve significantly with redshift. The stacked color-magnitude diagrams are used to define red and blue galaxies in clusters for studying their radial number density profiles without resorting to photometric redshifts of individual galaxies. We find that red galaxies are significantly more concentrated toward cluster centers and blue galaxies dominate the outskirt of clusters. We explore the fraction of red galaxies in clusters as a function of redshift, and find that the red fraction decreases with increasing distances from cluster centers. The red fraction exhibits a moderate decrease with increasing redshift. The radial number density profiles of cluster member galaxies are also used to infer the location of the steepest slope in the three dimensional galaxy density profiles. For a fixed threshold in richness, we find little redshift evolution in this location.Comment: 18pages, 10 figures, accepted as PASJ special issu

A new quadruple gravitational lens from the Hyper Suprime-Cam Survey: the puzzle of HSC~J115252+004733

We report the serendipitous discovery of a quadruply lensed source at $z_{\rm s}=3.76$, HSC~J115252+004733, from the Hyper Suprime-Cam (HSC) Survey. The source is lensed by an early-type galaxy at $z_{\rm l}=0.466$ and a satellite galaxy. Here, we investigate the properties of the source by studying its size and luminosity from the imaging and the luminosity and velocity width of the Ly-$\alpha$ line from the spectrum. Our analyses suggest that the source is most probably a low-luminosity active galactic nucleus (LLAGN) but the possibility of it being a compact bright galaxy (e.g., a Lyman-$\alpha$ emitter or Lyman Break Galaxy) cannot be excluded. The brighter pair of lensed images appears point-like except in the HSC $i$-band (with a seeing $\sim0.5"$). The extended emission in the $i$-band image could be due to the host galaxy underneath the AGN, or alternatively, due to a highly compact lensed galaxy (without AGN) which appears point-like in all bands except in $i$-band. We also find that the flux ratio of the brighter pair of images is different in the Ks-band compared to optical wavelengths. Phenomena such as differential extinction and intrinsic variability cannot explain this chromatic variation. While microlensing from stars in the foreground galaxy is less likely to be the cause, it cannot be ruled out completely. If the galaxy hosts an AGN, then this represents the highest redshift quadruply imaged AGN known to date, enabling study of a distant LLAGN. Discovery of this unusually compact and faint source demonstrates the potential of the HSC survey.Comment: 9 pages, 7 figures, 3 Tables, MNRAS accepted, text reduce