Failure of daptomycin monotherapy for endocarditis caused by an Enterococcus faecium strain with vancomycin-resistant and vancomycin-susceptible subpopulations and evidence of in vivo loss of the vanA gene cluster

被引：64
作者：
Arias, Cesar A.
Torres, Harrys A.
Singh, Kavindra V.
Panesso, Diana
Moore, Judson
Wanger, Audrey
Murray, Barbara E.
机构：
[1] Univ Texas, Sch Med, Ctr Study Emergin & Reemergin Pathogens, Houston, TX 77030 USA
[2] Univ Texas, Sch Med, Dept Internal Med, Div Infect Dis, Houston, TX 77030 USA
[3] Univ Texas, Sch Med, Dept Microbiol & Mol Genet, Houston, TX 77030 USA
[4] Univ Texas, Sch Med, Dept Pathol, Houston, TX 77030 USA
[5] Univ Texas, MD Anderson Canc Ctr, Dept Infect Dis Infect Control & Employee Hlth, Houston, TX 77030 USA
[6] Univ El Bosque, Mol Genet & Antimicrobial Resistance Unit, Bogota, Colombia
来源：
CLINICAL INFECTIOUS DISEASES | 2007年 / 45卷 / 10期
关键词：
D O I：
10.1086/522656
中图分类号：
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号：
100102 ;
摘要：
A patient with native valve endocarditis caused by a vancomycin "heteroresistant" strain of Enterococcus faecium experienced failure of daptomycin monotherapy without evidence of daptomycin resistance. The infecting organism exhibited in vivo emergence of a vancomycin-susceptible subpopulation lacking vanA. Treatment with a combination of high-dose daptomycin, gentamicin, and high-dose ampicillin cleared the infection.
引用
收藏
页码：1343 / 1346
页数：4
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