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Web End = Infection (2015) 43:751754
CASE REPORT
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Web End = DOI 10.1007/s15010-015-0763-0
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Web End = Received: 22 January 2015 / Accepted: 16 March 2015 / Published online: 25 March 2015 Springer-Verlag Berlin Heidelberg 2015
against VISA and VRSA [2]; however, its use can be limited by cross-resistance to vancomycin [3, 4]. Similarly, data on therapies for daptomycin non-susceptible (DNS) Staphylococcus aureus are limited. While vancomycin can be effective, its use can also be limited by cross-resistance [3, 4].
Ceftaroline fosamil is a broad spectrum beta-lactam antibiotic with anti-staphylococcal activity, currently approved in the United States for bacterial pneumonia and skin/ soft tissue infections, including those caused by MRSA. Beyond these indications, there is accumulating literature supporting its use as salvage therapy for VISA endocarditis as well as DNS Staphylococcus aureus infections [59].
We report an unusual case of dually resistant (daptomycin non-susceptible/vancomycin-intermediate) Staphylococcus aureus (DNS VISA) endocarditis in which a combination of ceftaroline and daptomycin achieved clearance of bacteremia. This report adds to the growing literature on the potential role of ceftaroline and daptomycin in treating highly drug-resistant Staphylococcus aureus infections.
Case report
An 81-year-old woman with diabetes and end-stage renal disease on hemodialysis presented to the hospital with chest pain and pleurisy. Vital signs and electrocardiogram (EKG) were unremarkable, troponin tests were negative, and the patient was discharged. Blood cultures were negative. One week later, the patient re-presented with recurrent chest pain, pleurisy, and new left-sided shoulder pain. Temperature was 38.7 C, pulse was 99 beats/min; blood pressure and oxygen saturation were normal. White blood cell (WBC) count was 12,600 106/L. Blood cultures were
drawn, empiric vancomycin and cefepime were initiated, and the patient was admitted to the hospital.
Daptomycin nonsusceptible, vancomycinintermediate Staphylococcus aureus endocarditis treated with ceftaroline and daptomycin: case report and brief review of the literature
Sanjiv M. Baxi1,2 Dominic Chan3 Vivek Jain4
Abstract We report a case of clearance of persistent bacteremia due to daptomycin non-susceptible, vancomycin-intermediate Staphylococcus aureus native mitral valve endocarditis with a combination of ceftaroline and daptomycin, in an 81-year-old medically complex patient who was not an operative candidate.
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