Giuseppe
Emeritus
[Source: BMC, full text: (LINK). Abstract, edited.]
Endocarditis caused by methicillin-susceptible Staphylococcus aureus with reduced susceptibility to vancomycin: a case report.
Beatriz Perazzi, Natalia Bello, Marta Mollerach, Carlos Vay, Maria BEATRIZ Lasala and Angela Famiglietti
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Journal of Medical Case Reports 2011, 5:292 doi:10.1186/1752-1947-5-292
Published: 7 July 2011
Abstract (provisional)
Introduction
Staphylococcus aureus is the most common cause of acute infective endocarditis. Recent reports have described heteroresistance to vancomycin associated with methicillin-resistant S. aureus. We present the first case report in Argentina of the failure of treatment with vancomycin in endocarditis caused by methicillin-susceptible S. aureus containing subpopulations with reduced susceptibility to vancomycin.
Case presentation
We report the case of a 66-year-old Hispanic man with infective endocarditis complicated by septic emboli in the lumbosacral spine and the left iliopsoas muscle. This disease was caused by methicillin-susceptible Staphylococcus aureus containing subpopulations with reduced susceptibility to vancomycin. The patient was initially treated with cephalothin and gentamicin but developed a rash caused by beta-lactams and interstitial nephritis. For that reason, the treatment was subsequently switched to vancomycin but the patient failed to respond. The infection resolved after administration of vancomycin in combination with gentamicin and rifampin.
Conclusion
This study provides important evidence for the existence of subpopulations of methicillin-susceptible S. aureus that have reduced susceptibility to vancomycin which would account for treatment failure in this case. Furthermore, this work raises an alert about the existence of these strains and highlights the need to determine the vancomycin minimum inhibitory concentration (MIC) of S. aureus to screen for the presence of strains that have reduced vancomycin susceptibility at different infection sites.
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Endocarditis caused by methicillin-susceptible Staphylococcus aureus with reduced susceptibility to vancomycin: a case report.
Beatriz Perazzi, Natalia Bello, Marta Mollerach, Carlos Vay, Maria BEATRIZ Lasala and Angela Famiglietti
For all author emails, please log on.
Journal of Medical Case Reports 2011, 5:292 doi:10.1186/1752-1947-5-292
Published: 7 July 2011
Abstract (provisional)
Introduction
Staphylococcus aureus is the most common cause of acute infective endocarditis. Recent reports have described heteroresistance to vancomycin associated with methicillin-resistant S. aureus. We present the first case report in Argentina of the failure of treatment with vancomycin in endocarditis caused by methicillin-susceptible S. aureus containing subpopulations with reduced susceptibility to vancomycin.
Case presentation
We report the case of a 66-year-old Hispanic man with infective endocarditis complicated by septic emboli in the lumbosacral spine and the left iliopsoas muscle. This disease was caused by methicillin-susceptible Staphylococcus aureus containing subpopulations with reduced susceptibility to vancomycin. The patient was initially treated with cephalothin and gentamicin but developed a rash caused by beta-lactams and interstitial nephritis. For that reason, the treatment was subsequently switched to vancomycin but the patient failed to respond. The infection resolved after administration of vancomycin in combination with gentamicin and rifampin.
Conclusion
This study provides important evidence for the existence of subpopulations of methicillin-susceptible S. aureus that have reduced susceptibility to vancomycin which would account for treatment failure in this case. Furthermore, this work raises an alert about the existence of these strains and highlights the need to determine the vancomycin minimum inhibitory concentration (MIC) of S. aureus to screen for the presence of strains that have reduced vancomycin susceptibility at different infection sites.
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