Emergence of a teicoplanin-resistant small colony variant of Staphylococcus epidermidis during vancomycin therapy.
Small colony variants of Staphylococcus aureus can cause persistent and recurrent infections. There are only a few reports of small colony variants of coagulase-negative staphylococci. Herein a case of infection with a teicoplanin-resistant small colony variant of Staphylococcus epidermidis is presented. The small colony variant was isolated from blood cultures of a patient with acute leukaemia and therapy-induced neutropenia who was treated with vancomycin for catheter-associated bloodstream infection. Despite removal of the catheter and adequate antibiotic therapy, the infection did not clear and the patient died 20 days after continuous antibiotic therapy.
Adler
H
H
Bacteriology Laboratory, University of Basel Hospitals and Clinics, Petersgraben 4, 4031 Basel, Switzerland. hadler@uhbs.ch
Widmer
A
A
Frei
R
R
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001769:Blood / Q000382:microbiology; D018450:Disease Progression; D024881:Drug Resistance, Bacterial; D017809:Fatal Outcome; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008826:Microbial Sensitivity Tests; D009503:Neutropenia / Q000188:drug therapy / Q000209:etiology; D018570:Risk Assessment; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000188:drug therapy*; D013212:Staphylococcus epidermidis / Q000302:isolation & purification*; D017334:Teicoplanin / Q000494:pharmacology*; D017211:Treatment Failure; D014640:Vancomycin / Q000627:therapeutic use*
D017334:Teicoplanin; D014640:Vancomycin