Daptomycin and methicillin-resistant Staphylococcus aureus isolated from a catheter-related bloodstream infection: a case report

Abstract

BackgroundDaptomycin is an alternative option for the treatment of catheter-related bloodstream-infections caused by methicillin-resistant Staphylococcus aureus. This study reports a case of a daptomycin and methicillin-resistant Staphylococcus aureus isolate recovered from the blood of a Brazilian patient undergoing hemodialysis.Case presentationA 64-year-old white male patient suffering from diabetes mellitus, systolic hypertension, heart disease with a coronary stent, obesity and chronic renal failure and on use of permcath catheter developed a catheter-related bloodstream-infection by a daptomycin-methicillin-resistant Staphylococcus aureus isolate after one month of daptomycin therapy. The isolate was identified as the SCCmec II/USA100/sequence type 5 lineage by molecular techniques.ConclusionsIn this work we described a Brazilian patient with bloodstream infection caused by a daptomycin and methicillin-resistant Staphylococcus aureus belonging to the lineage USA100/sequence type 5. Our case highlights the careful management of bloodstream infections and the importance of the judicious use of antimicrobials due the possibility of daptomycin-resistance developing among S. aureus isolates, especially in patients under hemodialysis, which are frequently exposed to vancomycin and daptomycin therapy.

Clinical and Microbiological Characteristics of Heteroresistant and Vancomycin-Intermediate Staphylococcus aureus from Bloodstream Infections in a Brazilian Teaching Hospital

“…In the present study, the results showed that although not all patients were located at the same ward, or even hospitalized at the same time, a possible dissemination of the USA100/ST5 lineage may have occurred in the hospital, probably carried by the hospital professionals. As in our study [ 13 ], we found that four of the six patients with BSI caused by VISA isolates had undergone dialysis treatment before isolation of a VISA strain. Vancomycin is a key antibiotic for the treatment of gram-positive infections and this may select for the VISA phenotype [ 7 ], [ 33 ], [ 34 ].…”

“…Despite a previous report of vancomycin resistant S . aureus (VRSA) isolated from a bloodstream infection in São Paulo in 2013 [ 10 ], hVISA [ 11 ] and VISA [ 12 ], [ 13 ] isolates appear to be uncommon in Brazil. We previously reported that 124 S .…”

Molecular characterization of methicillin-resistant Staphylococcus aureus isolated from blood in Rio de Janeiro displaying susceptibility profiles to non-β-lactam antibiotics

“…This lineage has also been observed in blood samples in Brazil, highlighting that one of these reports describes two isolates of S. aureus resistant to daptomycin. 27 In Brazil, to the best of our knowledge, there are few reports of USA600/ST45-MRSA-IV isolates, which were collected from skin infection case and from catheter. 23 , 28 …”

Non-microbial Natural Products That Inhibit Drug-Resistant Staphylococcus aureus

“…The emergence of daptomycin-resistant S. aureus is relatively uncommon. However, increasing records of daptomycin-resistant S. aureus have been reported [31][32][33].…”