title: Listeria grayi: vancomycin-resistant, gram-positive rod causing bacteremia in a stem cell transplant recipient.
abstract: We report the first case of Listeria grayi bacteremia in a stem cell transplant recipient. The patient developed bacteremia with a gram-positive rod that was initially thought to be Corynebacterium species and a skin contaminant. The organism grew in multiple blood cultures and therapy with vancomycin was initiated. The API Coryne (version 3.0) identified the organism as L. grayi. Susceptibility testing by Etest suggested that the organism was resistant to vancomycin, but susceptible to ampicillin. After therapeutic change from vancomycin to ampicillin, the bacteremia cleared. Empiric therapy with vancomycin for all gram-positive bacterial infections is not appropriate. Accurate identification and antibiotic susceptibility is important, particularly in those with persistent bacteremia.
authors.affiliation: Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan, USA. hsalimni@dmc.org
authors.forename: H
authors.initials: H
authors.lastname: Salimnia
authors.forename: D
authors.initials: D
authors.lastname: Patel
authors.forename: P R
authors.initials: PR
authors.lastname: Lephart
authors.forename: M R
authors.initials: MR
authors.lastname: Fairfax
authors.forename: P H
authors.initials: PH
authors.lastname: Chandrasekar
mesh_terms: D000328:Adult; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D016470:Bacteremia / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008087:Listeria / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D008088:Listeriosis / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D016896:Treatment Outcome; D014640:Vancomycin / Q000494:pharmacology* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D000667:Ampicillin