Abstract
We describe a patient who developed Corynebacterium striatum native valve endocarditis after receiving two 6-week courses of daptomycin for the treatment of methicillin-resistant Staphylococcus aureus bacteremia and osteomyelitis. The organism exhibited in vitro heteroresistance to daptomycin, with two subpopulations showing daptomycin susceptibility (MIC of ≤ 0.094 μg/ml) and high-level resistance to daptomycin (MIC of ≥ 256 μg/ml). The selection of daptomycin-resistant Gram-positive skin flora with the potential of causing invasive disease may be a concern during prolonged courses of daptomycin.
Publication types
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Case Reports
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Research Support, N.I.H., Extramural
MeSH terms
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Anti-Bacterial Agents / therapeutic use*
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Bacteremia / drug therapy
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Bacteremia / microbiology
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Corynebacterium / drug effects
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Corynebacterium / pathogenicity*
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Daptomycin / therapeutic use*
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Drug Resistance, Bacterial
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Endocarditis, Bacterial / microbiology*
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Endocarditis, Bacterial / pathology*
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Humans
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Male
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Methicillin-Resistant Staphylococcus aureus / drug effects
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Methicillin-Resistant Staphylococcus aureus / pathogenicity
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Middle Aged
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Osteomyelitis / drug therapy
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Osteomyelitis / microbiology
Substances
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Anti-Bacterial Agents
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Daptomycin