title: Clinical failure of vancomycin in a dialysis patient with methicillin-susceptible vancomycin-heteroresistant S. aureus.
abstract: 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.
authors.affiliation: Division of Infectious Diseases, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York 10065, USA.
authors.forename: Dahlene N
authors.initials: DN
authors.lastname: Fusco
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Alexander
authors.forename: Scott A
authors.initials: SA
authors.lastname: Weisenberg
authors.forename: Jose R
authors.initials: JR
authors.lastname: Mediavilla
authors.forename: Barry N
authors.initials: BN
authors.lastname: Kreiswirth
authors.forename: Audrey N
authors.initials: AN
authors.lastname: Schuetz
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Jenkins
authors.forename: Kyu Y
authors.initials: KY
authors.lastname: Rhee
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D008712:Methicillin