Abstract
High-dose daptomycin (DAP) therapy failed in a neutropenic patient with bloodstream infection caused by a DAP-susceptible Enterococcus faecium (minimum inhibitory concentration, 3 µg/mL) harboring genetic changes associated with DAP resistance, with persistent bacteremia and selection of additional resistances. Daptomycin monotherapy should be used cautiously against DAP-susceptible E. faecium strains with minimum inhibitory concentrations >2 µg/mL.
Keywords:
Enterococcus faecium; daptomycin; resistance; treatment failure.
© The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: [email protected].
Publication types
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Case Reports
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
MeSH terms
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Adult
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Anti-Bacterial Agents* / administration & dosage
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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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Chemotherapy-Induced Febrile Neutropenia
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Daptomycin* / administration & dosage
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Daptomycin* / therapeutic use
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Enterococcus faecium / drug effects*
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Enterococcus faecium / isolation & purification
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Fatal Outcome
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Gram-Positive Bacterial Infections* / drug therapy
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Gram-Positive Bacterial Infections* / microbiology
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Humans
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Male
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Microbial Sensitivity Tests
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Precursor Cell Lymphoblastic Leukemia-Lymphoma
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Treatment Failure
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Young Adult
Substances
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Anti-Bacterial Agents
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Daptomycin