Evidence map›Paper›PMID 26287490›Full record

SynthesisPloS one2015

Systematic Review and Meta-Analysis of the Epidemiology of Vancomycin-Intermediate and Heterogeneous Vancomycin-Intermediate Staphylococcus aureus Isolates.

Shanshan Zhang, Xiaoxi Sun, Wenjiao Chang, Yuanyuan Dai, Xiaoling Ma

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

70 citing papers in PubMed, 8 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Pooled it
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  6. Pooled it
  7. Pooled it
  8. Prevalence of vancomycin-resistant Enterococcus in Iran: a systematic review and meta-analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2016
    Pooled it
  9. Trial
  10. Article
  11. Article
  12. Prevention and Treatment ofPathogens (Basel, Switzerland) · 2026
    Review
  13. Microbiology spectrum · 2026
    Observational
  14. Article
  15. Article
  16. Mechanism, Efficacy, and Safety of Natural Antibiotics.Antibiotics (Basel, Switzerland) · 2025
    Review
  17. Review
  18. Article
  19. Article
  20. Molecular and Clinical Features of Heterogeneous Vancomycin-IntermediateSultan Qaboos University medical journal · 2023
    Article

10 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Shanshan ZhangSchool of Medicine, Shandong University, Ji'nan, 250061, PR China.
Xiaoxi SunDepartment of Clinical Laboratory, Affiliated Provincial Hospital of Anhui Medical University, Hefei, 230001, PR China.
Wenjiao ChangDepartment of Clinical Laboratory, Affiliated Provincial Hospital of Anhui Medical University, Hefei, 230001, PR China.
Yuanyuan DaiDepartment of Clinical Laboratory, Affiliated Provincial Hospital of Anhui Medical University, Hefei, 230001, PR China.
Xiaoling MaDepartment of Clinical Laboratory, Affiliated Provincial Hospital of Anhui Medical University, Hefei, 230001, PR China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVancomycin-intermediate Staphylococcus aureus (VISA) and heterogeneous VISA (hVISA) are associated with vancomycin treatment failure, and are becoming an increasing public health problem. Therefore, we undertook this study of 91 published studies and made subgroup comparisons of hVISA/VISA incidence in different study years, locations, and types of clinical samples. We also analyzed the genetic backgrounds of these strains.

methodsA systematic literature review of relevant articles published in PubMed and EMBASE from January 1997 to August 2014 was conducted. We selected and assessed journal articles reporting the prevalence rates of hVISA/VISA.

resultsThe pooled prevalence of hVISA was 6.05% in 99,042 methicillin-resistant S. aureus (MRSA) strains and that of VISA was 3.01% in 68,792 MRSA strains. The prevalence of hVISA was 4.68% before 2006, 5.38% in 2006-2009, and 7.01% in 2010-2014. VISA prevalence was 2.05%, 2.63%, and 7.93%, respectively. In a subgroup analysis of different isolation locations, the prevalence of hVISA strains was 6.81% in Asia and 5.60% in Europe/America, and that of VISA was 3.42% and 2.75%, respectively. The frequencies of hVISA isolated from blood culture samples and from all clinical samples were 9.81% and 4.68%, respectively, and those of VISA were 2.00% and 3.07%, respectively. The most prevalent genotype was staphylococcal cassette chromosome mec (SCCmec) II, which accounted for 48.16% and 37.74% of hVISA and VISA, respectively. Sequence Type (ST) 239 was most prevalent.

conclusionThe prevalence of hVISA/VISA has been increasing in recent years, but has been grossly underestimated. Its incidence is higher in Asia than in Europe/America. hVISA is isolated from blood culture samples more often than from other samples. These strains are highly prevalent in epidemic MRSA strains. This study clarifies the epidemiology of hVISA/VISA and indicates that the detection of these strains and the control of nosocomial infections must be strengthened.

Indexed as

Vancomycin ResistanceGenes, BacterialHumansMethicillin-Resistant Staphylococcus aureusPrevalenceStaphylococcal InfectionsStaphylococcus aureusTreatment Failure

Identifiers

PMID26287490
PMCPMC4546009

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.