title: Failure of combination therapy for Staphylococcus aureus bone infection: a case of in vivo selection with resistance to rifampicin and fusidic acid.
abstract: Staphylococcus aureus is one of the main etiologies of bone and device-related infections. Treatment of these orthopedic infections combines mostly rifampicin with other antibiotics. The recurrence or failure rate after fusidic acid/rifampicin treatment remains low (<10%). We discuss here a case of antibiotic treatment failure for Staphylococcus aureus bone infection with in vivo selection of rifampicin and fusidic acid resistance. We also report a new mutation in fusA gene involved in fusidic acid resistance.
authors.affiliation: a Service de Bactériologie-Hygiène hospitalière, CHU de Nantes, Institut de Biologie , Nantes Cedex , France ;|b Faculté de Médecine, EA3826 Thérapeutiques Cliniques et Expérimentales des Infections , Université de Nantes , Nantes , France ;|c Nantes study group members of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest) , Nantes , France ;
authors.forename: Guillaume G
authors.initials: GG
authors.lastname: Aubin
authors.affiliation: a Service de Bactériologie-Hygiène hospitalière, CHU de Nantes, Institut de Biologie , Nantes Cedex , France ;|c Nantes study group members of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest) , Nantes , France ;
authors.forename: Pascale
authors.initials: P
authors.lastname: Bémer
authors.affiliation: a Service de Bactériologie-Hygiène hospitalière, CHU de Nantes, Institut de Biologie , Nantes Cedex , France ;
authors.forename: Aurélie
authors.initials: A
authors.lastname: Guillouzouic
authors.affiliation: d Service de Pédiatrie , CHU de Nantes , Nantes , France ;
authors.forename: Elise
authors.initials: E
authors.lastname: Launay
authors.affiliation: e Service de Chirurgie Pédiatrique , CHU de Nantes , Nantes , France ;
authors.forename: Loïc
authors.initials: L
authors.lastname: Geffroy
authors.affiliation: c Nantes study group members of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest) , Nantes , France ;|f Service de Chirurgie Orthopédique Traumatologie , CHU de Nantes , Nantes , France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Touchais
authors.affiliation: a Service de Bactériologie-Hygiène hospitalière, CHU de Nantes, Institut de Biologie , Nantes Cedex , France ;|b Faculté de Médecine, EA3826 Thérapeutiques Cliniques et Expérimentales des Infections , Université de Nantes , Nantes , France ;|c Nantes study group members of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest) , Nantes , France ;
authors.forename: Stéphane
authors.initials: S
authors.lastname: Corvec
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001850:Bone Diseases, Infectious / Q000188:drug therapy / Q000382:microbiology; D024881:Drug Resistance, Bacterial / Q000235:genetics; D005672:Fusidic Acid / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008297:Male; D012293:Rifampin / Q000494:pharmacology / Q000627:therapeutic use; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D005672:Fusidic Acid; D012293:Rifampin
keywords: Biofilm; Staphylococcus aureus; bone; fusA; resistance; rpoB