SynthesisBMC infectious diseases2026
The global scope of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA): a meta-analysis of its clinical impact, molecular epidemiology, and diagnostic challenges across 15,165 isolates.
Synthesis in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo systematically evaluate the clinical impact of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA), characterize its global molecular epidemiology, and compare the accuracy of mainstream diagnostic screening methods.
methodsFollowing PRISMA guidelines, we systematically searched PubMed, Embase, and Web of Science for relevant literature published up to February 28, 2025. We conducted meta-analyses to calculate pooled odds ratios (ORs) for clinical outcomes, pooled prevalence for staphylococcal cassette chromosome mec (SCCmec) types, and synthesized the diagnostic accuracy of phenotypic screening methods using a bivariate random-effects model.
resultsA total of 59 studies were included, with a pooled hVISA prevalence of 12.0%. In clinical outcome analyses, hVISA infection was associated with higher odds of vancomycin treatment failure (OR = 2.68, 95% CI: 1.74-4.14) and a modest increase in all-cause mortality (OR = 1.35, 95% CI: 1.03-1.77). For persistent or recurrent bacteremia, the pooled estimate did not reach statistical significance (OR = 1.82, 95% CI: 0.62-5.34), and substantial heterogeneity was observed across studies. Molecular epidemiology analysis showed that SCCmec types II (26%) and III (22%) were predominant globally, with marked geographic variation. In diagnostic performance analysis, agar screening methods demonstrated higher pooled sensitivity (0.81) compared with Etest-based methods (0.73), whereas specificity was slightly lower (0.93 vs. 0.96). Overall diagnostic accuracy was comparable between methods, with overlapping summary AUC values (~ 0.92).
conclusionhVISA represents a clinically relevant phenotype associated with an increased likelihood of vancomycin treatment failure and a modest elevation in mortality risk. The association with persistent bacteremia remains uncertain due to limited data and heterogeneity. Geographic variation in molecular distribution was observed. Although agar screening methods demonstrated higher sensitivity for detection, substantial between-study heterogeneity warrants cautious interpretation of pooled diagnostic estimates.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.