title: Six cases of daptomycin-non-susceptible Staphylococcus aureus bacteraemia in Singapore.
abstract: We report what we believe to be the first six cases of daptomycin-non-susceptible Staphylococcus aureus infections from Singapore. These strains were rapidly isolated after bacteraemic patients were switched to daptomycin following initial prolonged unsuccessful therapy with vancomycin, despite confirmation of daptomycin susceptibility just prior to initiating daptomycin therapy. The majority of post-vancomycin therapy strains exhibited marked thickening of their cell walls on electron microscopic examination. In patients with persistent S. aureus bacteraemia, therapeutic failure with daptomycin may occur if used as salvage therapy following vancomycin failure, notwithstanding initial susceptibility testing results.
authors: National University Health System, Singapore.
authors: Li-Yang
authors: LY
authors: Hsu
authors: National University Health System, Singapore.
authors: Micky
authors: M
authors: Leong
authors: National University Health System, Singapore.
authors: Michelle
authors: M
authors: Balm
authors: National University Health System, Singapore.
authors: Douglas S
authors: DS
authors: Chan
authors: National University Health System, Singapore.
authors: Paul
authors: P
authors: Huggan
authors: Changi General Hospital, Singapore.
authors: Thean-Yen
authors: TY
authors: Tan
authors: Singapore General Hospital, Singapore.
authors: Tse-Hsien
authors: TH
authors: Koh
authors: National University Health System, Singapore.
authors: Pei-Yun
authors: PY
authors: Hon
authors: National University Health System, Singapore.
authors: Mary M
authors: MM
authors: Ng
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D017576:Daptomycin / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012846:Singapore / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents; D017576:Daptomycin