Six cases of daptomycin-non-susceptible Staphylococcus aureus bacteraemia in Singapore.
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.
Hsu
Li-Yang
LY
National University Health System, Singapore.
Leong
Micky
M
National University Health System, Singapore.
Balm
Michelle
M
National University Health System, Singapore.
Chan
Douglas S
DS
National University Health System, Singapore.
Huggan
Paul
P
National University Health System, Singapore.
Tan
Thean-Yen
TY
Changi General Hospital, Singapore.
Koh
Tse-Hsien
TH
Singapore General Hospital, Singapore.
Hon
Pei-Yun
PY
National University Health System, Singapore.
Ng
Mary M
MM
National University Health System, Singapore.
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*
D000900:Anti-Bacterial Agents; D017576:Daptomycin