Emergence of Daptomycin-Resistant Staphylococcus aureus during Treatment

Intern Med. 2016;55(1):73-8. doi: 10.2169/internalmedicine.55.4763.

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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / pharmacology
  • Bacteremia
  • Catheterization, Central Venous / adverse effects*
  • Catheters, Indwelling / adverse effects
  • Catheters, Indwelling / microbiology*
  • Cell Wall
  • Daptomycin
  • Fatal Outcome
  • Humans
  • Linezolid / administration & dosage*
  • Linezolid / pharmacology
  • Male
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • Microbial Sensitivity Tests
  • Osteomyelitis / drug therapy*
  • Psoas Abscess / drug therapy*
  • Staphylococcal Infections / complications
  • Staphylococcal Infections / microbiology*
  • Staphylococcus aureus / drug effects*

Substances

  • Anti-Bacterial Agents
  • Linezolid
  • Daptomycin