| Literature DB >> 22162601 |
Suttirak Chaiwongkarjohn1, Pornpoj Pramyothin, Nuntra Suwantarat, Matthew J Bankowski, Terrie Koyamatsu, Steven E Seifried, Erlaine F Bello.
Abstract
The state of Hawai'i has the highest prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infection in the United States. Since vancomycin is the most frequently-prescribed antibiotic for healthcare-associated MRSA infection, there is concern for development of vancomycin resistance. We report on a 61 year-old woman with history of previous successful treatments of MRSA bacteremia with vancomycin. She was later hospitalized for catheter-related MRSA bacteremia that persisted despite vancomycin treatment. The vancomycin minimal inhibitory concentration (MIC) was initially 1-2 µg/ml, suggesting susceptibility, but changed to 4 µg/ml. At this level, the organism was classified as a vancomycin-intermediate Staphylococcus aureus (VISA). Therapy was changed from vancomycin to daptomycin, and the patient's blood cultures were sterilized. High suspicion of VISA should be raised in MRSA-infected patients who fail or have a history of vancomycin therapy so that additional susceptibility testing and appropriate antibiotic therapy can be promptly commenced to reduce the morbidity associated with VISA infection.Entities:
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Year: 2011 PMID： 22162601 PMCID： PMC3215986
Source DB: PubMed Journal: Hawaii Med J ISSN： 0017-8594