Emergence of Dalbavancin, Vancomycin, and Daptomycin Nonsusceptible Staphylococcus aureus in a Patient Treated With Dalbavancin: Case Report and Isolate Characterization

Clin Infect Dis. 2022 Oct 29;75(9):1641-1644. doi: 10.1093/cid/ciac341.

Abstract

A patient with end-stage renal disease received 2 doses of dalbavancin for methicillin-resistant Staphylococcus aureus (MRSA) arteriovenous fistula infection and presented 5 weeks later with infective endocarditis secondary to vancomycin, daptomycin, and dalbavancin nonsusceptible MRSA. Resistance was associated with walK and scrA mutations, reduced long-chain lipid content, and reduced membrane fluidity.

Keywords: dalbavancin relapse; dalbavancin resistance; lipoglycopeptide cross-resistance; walK mutation.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Daptomycin* / pharmacology
  • Daptomycin* / therapeutic use
  • Humans
  • Methicillin-Resistant Staphylococcus aureus* / genetics
  • Microbial Sensitivity Tests
  • Staphylococcal Infections* / drug therapy
  • Staphylococcus aureus
  • Teicoplanin / pharmacology
  • Teicoplanin / therapeutic use
  • Vancomycin / pharmacology
  • Vancomycin / therapeutic use

Substances

  • dalbavancin
  • Vancomycin
  • Daptomycin
  • Anti-Bacterial Agents
  • Teicoplanin