Native valve endocarditis caused by corynebacterium striatum with heterogeneous high-level daptomycin resistance: collateral damage from daptomycin therapy?
Tran, Truc T.
Lewis, Cole T.
Kaplan, Heidi B.
Wanger, Audrey R.
Arias, César A.
Antimicrobial agents and chemotherapy, 1098-6596, Vol. 56, Nro. 6, 2012, p. 3461-3464
American Society for Microbiology
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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.
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