title: Quinupristin/dalfopristin (RP 59500) therapy for vancomycin-resistant Enterococcus faecium aortic graft infection: case report.
abstract: A 46-year-old woman was admitted to the hospital with severe peripheral vascular disease, requiring multiple vascular surgical procedures. During the sixth hospital week, after prior therapy with multiple antibiotics, Enterococcus faecium was isolated as the only organism from an operating room culture of an infected aortic graft. Histological examination of the graft showed infiltration with polymorphonuclear leukocytes. Subsequently, cultures of an infected inguinal wound yielded Enterococcus faecium with mixed bacterial growth. Both isolates of Enterococcus faecium were resistant to all available antimicrobials, including ampicillin, vancomycin, tetracycline, chloramphenicol, and ciprofloxacin. Compassionate use therapy with quinupristin/dalfopristin (RP59500) was administered for 25 days, the patient's clinical condition improved, and wound healing occurred. Transient elevation of serum alkaline phosphatase was noted. This case demonstrates successful eradication of deep VREF infection by quinupristin/dalfopristin with good tolerance of prolonged therapy.
authors.affiliation: Department of Medicine, New York Hospital Medical Center of Queens, Flushing 11355, USA.
authors.forename: V S
authors.initials: VS
authors.lastname: Sahgal
authors.forename: C
authors.initials: C
authors.lastname: Urban
authors.forename: N
authors.initials: N
authors.lastname: Mariano
authors.forename: F
authors.initials: F
authors.lastname: Weinbaum
authors.forename: J
authors.initials: J
authors.lastname: Turner
authors.forename: J J
authors.initials: JJ
authors.lastname: Rahal
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001158:Arteries / Q000382:microbiology / Q000473:pathology; D001026:Coronary Artery Bypass; D004352:Drug Resistance, Microbial; D016984:Enterococcus faecium; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D014640:Vancomycin / Q000494:pharmacology; D014769:Virginiamycin / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D014769:Virginiamycin; C062940:quinupristin-dalfopristin; D014640:Vancomycin