Failure of high-dose daptomycin for bacteremia caused by daptomycin-susceptible Enterococcus faecium harboring LiaSR substitutions

Jose M Munita; Nagendra N Mishra; Danya Alvarez; Truc T Tran; Lorena Diaz; Diana Panesso; Jinnethe Reyes; Barbara E Murray; Javier A Adachi; Arnold S Bayer; Cesar A Arias

doi:10.1093/cid/ciu642

Failure of high-dose daptomycin for bacteremia caused by daptomycin-susceptible Enterococcus faecium harboring LiaSR substitutions

Clin Infect Dis. 2014 Nov 1;59(9):1277-80. doi: 10.1093/cid/ciu642. Epub 2014 Aug 8.

Authors

Affiliations

¹ Division of Infectious Diseases, Department of Internal Medicine Division of Infectious Diseases, Department of Medicine, Clinica Alemana de Santiago, Universidad del Desarrollo, Chile.
² Geffen School of Medicine at University of California at Los Angeles Los Angeles Biomedical Research Institute, Torrance, California.
³ Geffen School of Medicine at University of California at Los Angeles.
⁴ Division of Infectious Diseases, Department of Internal Medicine.
⁵ Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogotá, Colombia.
⁶ Division of Infectious Diseases, Department of Internal Medicine Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogotá, Colombia.
⁷ Division of Infectious Diseases, Department of Internal Medicine Department of Microbiology and Molecular Genetics, University of Texas Medical School.
⁸ Division of Infectious Diseases, Department of Medicine, MD Anderson Cancer Center, Houston.
⁹ Division of Infectious Diseases, Department of Internal Medicine Department of Microbiology and Molecular Genetics, University of Texas Medical School Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogotá, Colombia.

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.

Publication types

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

MeSH terms

Adult
Anti-Bacterial Agents* / administration & dosage
Anti-Bacterial Agents* / therapeutic use
Bacteremia* / drug therapy
Bacteremia* / microbiology
Chemotherapy-Induced Febrile Neutropenia
Daptomycin* / administration & dosage
Daptomycin* / therapeutic use
Enterococcus faecium / drug effects*
Enterococcus faecium / isolation & purification
Fatal Outcome
Gram-Positive Bacterial Infections* / drug therapy
Gram-Positive Bacterial Infections* / microbiology
Humans
Male
Microbial Sensitivity Tests
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Treatment Failure
Young Adult

Substances

Anti-Bacterial Agents
Daptomycin

Abstract

Publication types

MeSH terms

Substances

Grants and funding