Daptomycin-resistant Enterococcus faecium in a patient with acute myeloid leukemia.
Daptomycin is a lipopeptide antimicrobial used for the treatment of aerobic gram-positive skin and soft tissue infections. We describe a patient with acute myeloid leukemia whose febrile neutropenia was treated with daptomycin and who later developed daptomycin-resistant Enterococcus faecium infection. Defervescence and negative blood cultures ensued after treatment with linezolid. Guidelines for testing daptomycin susceptibillities of enterococci include breakpoints only for vancomycin-susceptible Enterococcus faecalis, making interpretation of minimum inhibitory concentrations for common clinical infections difficult. No enterococcal cross-resistance has been reported among daptomycin, linezolid, or quinupristin-dalfopristin, and these agents may be viable alternatives.
Long
Jennifer K
JK
Department of Pharmacy, Clinical Microbiology Section, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Choueiri
Toni K
TK
Hall
Geraldine S
GS
Avery
Robin K
RK
Sekeres
Mikkael A
MA
D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017576:Daptomycin; D024881:Drug Resistance, Bacterial; D016984:Enterococcus faecium; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007951:Leukemia, Myeloid / Q000150:complications* / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D017576:Daptomycin