title: Emergence of Daptomycin-Resistant Staphylococcus aureus during Treatment.
abstract: A 68-year-old man with persistent bacteremia accompanying a large iliopsoas abscess, vertebral osteomyelitis, discitis and central venous port infection caused by methicillin-resistant Staphylococcus aureus (MRSA) was admitted to our hospital. During the course of treatment, the emergence of a daptomycin (DAP)-resistant MRSA strain was confirmed; the minimum inhibitory concentration was 1 to 2 μg/mL for vancomycin and more than 1 μg/mL for DAP. Although the bacterial cell wall was not significantly thickened, an increased positive surface charge and single-nucleotide polymorphism within mprF have been confirmed in DAP-resistant strains. Still rare, but clinicians need to be cautious of the emergence of DAP-resistant MRSA during treatment.
authors.affiliation: Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
authors.forename: Hideharu
authors.initials: H
authors.lastname: Hagiya
authors.forename: Yuto
authors.initials: Y
authors.lastname: Haruki
authors.forename: Taeko
authors.initials: T
authors.lastname: Uchida
authors.forename: Tomoko
authors.initials: T
authors.lastname: Wada
authors.forename: Sumiko
authors.initials: S
authors.lastname: Shiota
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Ishida
authors.forename: Hiroko
authors.initials: H
authors.lastname: Ogawa
authors.forename: Tomoko
authors.initials: T
authors.lastname: Murase
authors.forename: Fumio
authors.initials: F
authors.lastname: Otsuka
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology; D016470:Bacteremia; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000382:microbiology*; D002473:Cell Wall; D017576:Daptomycin; D017809:Fatal Outcome; D006801:Humans; D000069349:Linezolid / Q000008:administration & dosage* / Q000494:pharmacology; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D008826:Microbial Sensitivity Tests; D010019:Osteomyelitis / Q000188:drug therapy*; D016659:Psoas Abscess / Q000188:drug therapy*; D013203:Staphylococcal Infections / Q000150:complications / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents; D000069349:Linezolid; D017576:Daptomycin