Daptomycin Failure for Treatment of Pulmonary Septic Emboli in Native Tricuspid and Mitral Valve Methicillin-Resistant<i>Staphylococcus aureus</i>Endocarditis

Zainah, Hadeel; Zervos, Marcus J.; Stephane, Wassim; Alhelo, Sara Chamas; Alkhoury, Ghattas; Weinmann, Allison

doi:10.1155/2013/653582

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…These strains of MRSA have been associated with poorer prognosis, greater treatment failure and higher mortality, especially with bacteraemia, compared to non-bacteraemic patients 7–9. Daptomycin is considered first-line therapy for MRSA with higher vancomycin MICs, and is as efficacious as vancomycin or vancomycin/gentamycin combination therapy for treatment of MRSA RIE 17. However, since daptomycin is inactivated by alveolar surfactant, its efficacy in the treatment of RIE complicated by septic pulmonary emboli and/or pneumonia is unclear 17.…”

Section: Discussionmentioning

confidence: 99%

“…Daptomycin is considered first-line therapy for MRSA with higher vancomycin MICs, and is as efficacious as vancomycin or vancomycin/gentamycin combination therapy for treatment of MRSA RIE 17. However, since daptomycin is inactivated by alveolar surfactant, its efficacy in the treatment of RIE complicated by septic pulmonary emboli and/or pneumonia is unclear 17. A combination of daptomycin and ceftaroline (salvage therapy) is highly bactericidal against MRSA strains with reduced susceptibility to glycopeptides, lipopeptides or even daptomycin itself 18 19.…”

Section: Discussionmentioning

confidence: 99%

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Tricuspid and mitral endocarditis due to methicillin-resistantStaphylococcus aureusexhibiting vancomycin-creep phenomenon

et al. 2015

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SUMMARYRight-sided infective endocarditis (RIE) is commonly due to Staphylococcus aureus and often involves the tricuspid valve (TV). A 31-year-old man with prior intravenous drug use presented with substernal pain, cough, dyspnoea and fever. Examination revealed a febrile, tachycardic male with peripheral infective endocarditis stigmata and right-heart failure. Laboratory parameters demonstrated leucocytosis, lactic acidosis and methicillinresistant S. aureus (MRSA) bacteraemia. Echocardiography demonstrated multiple TV echodensities and chest imaging confirmed septic emboli. The MRSA species demonstrated 'vancomycincreep', necessitating therapy with daptomycin and ceftaroline. Owing to persistent bacteraemia and septic shock, the patient underwent TV surgery, but continued to have a poor postoperative course with subsequent death. Indications for surgical therapy of RIE are limited to the European guidelines and most data are extrapolated from left-heart disease. MRSA exhibiting vancomycin-creep portends a poorer prognosis and requires aggressive therapy. We advocate the use of ceftaroline salvage therapy with daptomycin, pending further trials. BACKGROUND

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Tricuspid and mitral endocarditis due to methicillin-resistantStaphylococcus aureusexhibiting vancomycin-creep phenomenon

et al. 2015

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Sepsis and Fever in the Neuro-Critical Care Unit (NCCU)

Pingili

Arora

2022

Procedures and Protocols in the Neurocritical Care Unit

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Tricuspid Valve Endocarditis Due to Methicillin-Resistant Staphylococcus aureus in a Previously Healthy Young Patient without a Drug Abuse History: A Case Report and a Review of the Literature

Andrijašević,

Perešin Vranjković,

Dobrović

et al. 2023

Infectious Disease Reports

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Right-sided infective endocarditis due to methicillin-resistant Staphylococcus aureus (MRSA) is strongly associated with intravenous drug abuse, congenital heart disease, or previous medical treatment and is rare in healthy patients without a history of drug abuse. Here, we present a case of an 18-year-old male with no drug abuse history and no medical burden who was diagnosed with MRSA tricuspid valve endocarditis. Due to initial symptoms which indicated community-acquired pneumonia and radiological finding of interstitial lesions, empiric therapy with ceftriaxone and azithromycin was started. After the detection of Gram-positive cocci in clusters in several blood culture sets, endocarditis was suspected, and flucloxacillin was added to the initial therapy. As soon as methicillin resistance was detected, the treatment was switched to vancomycin. Transesophageal echocardiography established the diagnosis of right-sided infective endocarditis. A toxicological analysis of hair was carried out, and no presence of narcotic drugs was found. After six weeks of therapy, the patient was fully recovered. Exceptionally, tricuspid valve endocarditis can be diagnosed in previously healthy people who are not drug addicts. As the clinical presentation commonly resembles a respiratory infection, a misdiagnosis is possible. Although MRSA rarely causes community-acquired infections in Europe, clinicians should be aware of this possibility.

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Daptomycin Failure for Treatment of Pulmonary Septic Emboli in Native Tricuspid and Mitral Valve Methicillin-ResistantStaphylococcus aureusEndocarditis

Cited by 5 publications

References 15 publications

Tricuspid and mitral endocarditis due to methicillin-resistantStaphylococcus aureusexhibiting vancomycin-creep phenomenon

Tricuspid and mitral endocarditis due to methicillin-resistantStaphylococcus aureusexhibiting vancomycin-creep phenomenon

Sepsis and Fever in the Neuro-Critical Care Unit (NCCU)

Tricuspid Valve Endocarditis Due to Methicillin-Resistant Staphylococcus aureus in a Previously Healthy Young Patient without a Drug Abuse History: A Case Report and a Review of the Literature

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