Clinical failure of vancomycin in a dialysis patient with methicillin-susceptible vancomycin-heteroresistant S. aureus.
We report a case of recurrent Staphylococcus aureus bacteremia in a patient who failed vancomycin due to a vancomycin-heteroresistant strain lacking methicillin resistance. Although initial isolates were susceptible, isolates obtained after vancomycin chemotherapy were vancomycin heteroresistant. This case thus illustrates the clinical emergence of vancomycin heteroresistance.
Fusco
Dahlene N
DN
Division of Infectious Diseases, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York 10065, USA.
Alexander
Elizabeth L
EL
Weisenberg
Scott A
SA
Mediavilla
Jose R
JR
Kreiswirth
Barry N
BN
Schuetz
Audrey N
AN
Jenkins
Stephen G
SG
Rhee
Kyu Y
KY
D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D008712:Methicillin / Q000494:pharmacology; D008875:Middle Aged; D006435:Renal Dialysis; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D017211:Treatment Failure; D014640:Vancomycin / Q000494:pharmacology / Q000627:therapeutic use*; D020713:Vancomycin Resistance
D000900:Anti-Bacterial Agents; D014640:Vancomycin; D008712:Methicillin