title: Failure of high-dose daptomycin for bacteremia caused by daptomycin-susceptible Enterococcus faecium harboring LiaSR substitutions.
abstract: High-dose daptomycin (DAP) therapy failed in a neutropenic patient with bloodstream infection caused by a DAP-susceptible Enterococcus faecium (minimum inhibitory concentration, 3 µg/mL) harboring genetic changes associated with DAP resistance, with persistent bacteremia and selection of additional resistances. Daptomycin monotherapy should be used cautiously against DAP-susceptible E. faecium strains with minimum inhibitory concentrations >2 µg/mL.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine Division of Infectious Diseases, Department of Medicine, Clinica Alemana de Santiago, Universidad del Desarrollo, Chile.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Munita
authors.affiliation: Geffen School of Medicine at University of California at Los Angeles Los Angeles Biomedical Research Institute, Torrance, California.
authors.forename: Nagendra N
authors.initials: NN
authors.lastname: Mishra
authors.affiliation: Geffen School of Medicine at University of California at Los Angeles.
authors.forename: Danya
authors.initials: D
authors.lastname: Alvarez
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine.
authors.forename: Truc T
authors.initials: TT
authors.lastname: Tran
authors.affiliation: Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogotá, Colombia.
authors.forename: Lorena
authors.initials: L
authors.lastname: Diaz
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogotá, Colombia.
authors.forename: Diana
authors.initials: D
authors.lastname: Panesso
authors.affiliation: Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogotá, Colombia.
authors.forename: Jinnethe
authors.initials: J
authors.lastname: Reyes
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine Department of Microbiology and Molecular Genetics, University of Texas Medical School.
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Murray
authors.affiliation: Division of Infectious Diseases, Department of Medicine, MD Anderson Cancer Center, Houston.
authors.forename: Javier A
authors.initials: JA
authors.lastname: Adachi
authors.affiliation: Geffen School of Medicine at University of California at Los Angeles Los Angeles Biomedical Research Institute, Torrance, California.
authors.forename: Arnold S
authors.initials: AS
authors.lastname: Bayer
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine Department of Microbiology and Molecular Genetics, University of Texas Medical School Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogotá, Colombia.
authors.forename: Cesar A
authors.initials: CA
authors.lastname: Arias
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology; D064146:Chemotherapy-Induced Febrile Neutropenia; D017576:Daptomycin / Q000008:administration & dosage / Q000627:therapeutic use; D016984:Enterococcus faecium / Q000187:drug effects* / Q000302:isolation & purification; D017809:Fatal Outcome; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D017576:Daptomycin
keywords: Enterococcus faecium; daptomycin; resistance; treatment failure
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