Daptomycin as a possible new treatment option for surgical management of Methicillin-Resistant Staphylococcus aureus sternal wound infection after cardiac surgery

Popov, Aron Frederik; Schmitto, Jan D.; Tirilomis, Theodor; Bireta, Christian; Coskun, Kasim Oguz; Mokashi, Suyog A.; Emmert, Alexander; Friedrich, Martin; Wiese, Christoph H.R.; Schoendube, Friedrich A.

doi:10.1186/1749-8090-5-57

Cited by 9 publications

(10 citation statements)

References 17 publications

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“…Interestingly, data on the optimal antibiotic management or duration of therapy for DSWI is scarce. Daptomycin has shown to be effective combined with multiple surgeries for treatment of DSWI in cardiac surgery [1,3,4]. However, up till now, no study has shown midterm results in terms of re-infection or re-operation for patients who were successfully treated with daptomycin for gram-positive DSWI.…”

Section: Resultsmentioning

confidence: 99%

Midterm results after treatment of gram-positive deep sternal wound infections with daptomycin for cardiac surgery patients

Ort

Jebran

Bireta

et al. 2013

J Cardiothorac Surg

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Daptomycin in combination with surgical therapy has shown to be effective for treatment of deep sternal wound infection in cardiac surgery. However, till now midterm results in terms of re-infection or re-operation in patients who were successfully treated with daptomycin for gram-positive deep sternal wound infection are not published. Herein, we present midterm results in patients treated successfully with daptomycin after cardiac surgery.

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Section: Resultsmentioning

confidence: 99%

Midterm results after treatment of gram-positive deep sternal wound infections with daptomycin for cardiac surgery patients

Ort

Jebran

Bireta

et al. 2013

J Cardiothorac Surg

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“…For these highly specific infections Daptomycin has proved to be an effective treatment [1,4,5]. To prevent prolonged hospitalisation and need for device exchange, we recommend an aggressive antibiotic therapy with Daptomycin combined with local debridement and vacuum treatment in infected wound cavities.…”

Section: Discussionmentioning

confidence: 99%

Eradication of a chronic wound and driveline infection after redo-LVAD implantation

Walter

Stock

Soriano-Romero

et al. 2014

J Cardiothorac Surg

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A 48 year old patient with dilated cardiomyopathy and chronic acne inversa underwent implantation of a LVAD system (Heartmate II, Thoratec, USA) March 2011. During 2011 and 2012 the patient was repeatedly readmitted for treatment of driveline infection with MRSA. Colonization was controlled with Linezolid and Rifampicin however reoccurred after discontinuation. In August 2012 the LVAD-system was exchanged due to pump dysfunction (HVAD, HeartWare Inc., USA). Postoperatively, the patient presented with ascites which secreted through the driveline exit. Consequently, the abdominal wall was surgically corrected to prevent exit of peritoneal fluid through the driveline, and the patient was discharged with sterile wound swabs. However 6 weeks after discharge the driveline exit wound started secreting pus showing abundant growth of multi resistant staphylococcus aureus (MRSA). With clinical signs of increasing liver failure with regular need for paracentesis, and clinical signs of local infection, a CT scan of the abdomen was performed revealing an enrichment of contrast medium along the driveline and an abscess-like formation on the abdominal wall. Patient was admitted receiving regular dose Daptomycin and Rifampicin. The latter was discontinued after ten days. The abscess, surrounding driveline exit and abdominal wall cavity was excised and vacuum treatment initiated. Total duration of Daptomycin therapy was 3 weeks. While first week skin and wound swabs were still positive for MRSA, all samples were sterile after the second week. Inflammation was monitored by leucocyte count and IL6. The secretion of pus along the driveline ceased, the wound cavity was closed subsequently. After discharge and stop of antibiotics skin and driveline swabs remained negative for MRSA (10 weeks).

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“…Как известно, стафилококк является наиболее распространенным патогеном, выделяемым при инфекциях кожи и мягких тканей, который нередко демонстрирует резистентность к антибиотикам широкого спектра и требует длительной антибактериальной терапии. Даптомицин, первый антибиотик из класса циклических липопептидов, обладает доказанной эффективностью при лечении бактериемий и инфекционных осложнений в кардиохирургии, включая эндокардиты, обусловленные метициллинрезистентными штаммами стафилококков [15,16]. В связи с большей (в сравнении с ванкомицином) пенетрацией препарата в костную и периартикулярные ткани терапия даптомицином успешна при развитии остеомие- [17].…”

Section: пациенты и методыunclassified

Daptomycin in treatment of Gram-positive infections in children with hematological disorders

Дышлевая¹,

Архипова²,

Пашко³

et al. 2012

Vopr. sovr. pediatr.

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The study of efficacy and toxicity of daptoycin in treatment of Gram-positive infectons n children with hematological disorders was performed. Twelve patients (4 girls and 8 boys) with signs of Gram-positive infections were examined. Staphylococcus aureus was found in 66,6% (8 patients), among them in 3 patients strains were methicillin-resistant; Staphylococcus epidermidis-was found in 16,6% (2 patients); Enterococcus faecalis-in 16,6% (2 patients). By the time of development of infectious complications 7 patients (58,3%) have received antibiotic treatment, in 5 other patients daptomycin was the first-line antibacterial drug. The mean dosage of the drug was 5,8 mg/kg/day. In order to reveal the drug toxicity the monitoring of biochemical serum markers (fibrinogen, ALT, AST, LDG, CPK, creatinine) was performed. The complete resolution of infectious complications occurred in 12,1 ± 4,3 days. The mean duration of daptomycin treatment was 14,2 ± 3,2 days. During the treatment reliable lower of fibrinogen (6,4 ± 1,1 g/l and 3,1 ± 0,9 g/l, р = 0,05) and c-reactive protein (CRP) (12,5 ± 7,1 mg/dL and 3,4 ± 1,8 mg/dL, р = 0,04) was observed. No side effects were observed in all the patients. The performed study allowed to make a conclusion, that daptomycin is an effective and safe drug in treatment of Grampositive infections in children with hematological disorders even with concomitant hypogranulocytosis.

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Daptomycin as a possible new treatment option for surgical management of Methicillin-Resistant Staphylococcus aureus sternal wound infection after cardiac surgery

Cited by 9 publications

References 17 publications

Midterm results after treatment of gram-positive deep sternal wound infections with daptomycin for cardiac surgery patients

Midterm results after treatment of gram-positive deep sternal wound infections with daptomycin for cardiac surgery patients

Eradication of a chronic wound and driveline infection after redo-LVAD implantation

Daptomycin in treatment of Gram-positive infections in children with hematological disorders

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