1887

Abstract

Introduction:

Vancomycin remains the mainstay in the treatment of meticillin‐resistant (MRSA) bacteraemia; however, concerns exist about its continued efficacy in the presence of rising MICs. Daptomycin serves as an alternative but has also witnessed increases in reduced susceptibility. Several published case reports have demonstrated the potential utility of ceftaroline as a viable therapeutic option for invasive MRSA infections, including endocarditis.

Case presentation:

A 23‐year‐old pregnant female presented with complaints of foot pain and fevers up to 104 °F. Her past medical history included polysubstance abuse, hepatitis C, intravenous drug use and a right arm abscess 2 years ago due to MRSA. Daptomycin was started empirically due to an allergy (angioedema) to vancomycin. Blood cultures returned positive for MRSA and remained persistently positive for 10 days at which point ceftaroline was added. Subsequent positive blood cultures on day 12 revealed daptomycin‐non‐susceptible MRSA at an MIC of 4 µg ml. Consequently, daptomycin was discontinued and gentamicin was added. Blood cultures were negative by day 14 and the patient completed a total of 2 weeks of gentamicin and 4 weeks of ceftaroline after the first negative blood culture. The baby was born premature at 34 weeks and 2 days due to complications of pregnancy; however, no adverse effects of antimicrobial therapy were noted.

Conclusion:

We describe the emergence of daptomycin‐non‐susceptibility during treatment and the successful eradication of persistent daptomycin‐non‐susceptible MRSA bacteraemia and endocarditis with a combination of ceftaroline and gentamicin in a pregnant female.

Loading

Article metrics loading...

/content/journal/jmmcr/10.1099/jmmcr.0.002394
2014-06-01
2019-10-14
Loading full text...

Full text loading...

/deliver/fulltext/jmmcr/1/2/jmmcr002394.html?itemId=/content/journal/jmmcr/10.1099/jmmcr.0.002394&mimeType=html&fmt=ahah

References

  1. Boucher H.W. , Talbot G.H. , Bradley J.S. , Edwards J.E. , Gilbert D. , Rice L.B. , Scheld M. , Spellberg B. , Bartlett J. . ( 2009; ). Bad bugs, no drugs: no ESKAPE! An update from the Infectious Diseases Society of America. . Clin Infect Dis 48:, 1–12.[CrossRef]
    [Google Scholar]
  2. Ho T.T. , Cadena J. , Childs L.M. , Gonzalez‐Velez M. , Lewis J.S.II. . ( 2012; ). Methicillin‐resistant Staphylococcus aureus bacteraemia and endocarditis treated with ceftaroline salvage therapy. . J Antimicrob Chemotherapy 67:, 1267–1270.[CrossRef]
    [Google Scholar]
  3. Jongsma K. , Joson J. , Heidari A. . ( 2013; ). Ceftaroline in the treatment of concomitant methicillin‐resistant and daptomycin‐non‐susceptible Staphylococcus aureus infective endocarditis and osteomyelitis: case report. . J Antimicrob Chemotherapy 68:, 1444–1445.[CrossRef]
    [Google Scholar]
  4. Lin J.C. , Aung G. , Thomas A. , Jahng M. , Johns S. , Fierer J. . ( 2013; ). The use of ceftaroline fosamil in methicillin‐resistant Staphylococcus aureus endocarditis and deep‐seated MRSA infections: a retrospective case series of 10 patients. . J Infection Chemotherapy 19:, 42–49.[CrossRef]
    [Google Scholar]
  5. Polenakovik H.M. , Pleiman C.M. . ( 2013; ). Ceftaroline for meticillin‐resistant Staphylococcus aureus bacteraemia: case series and review of the literature. . Int J Antimicrob Agents 42:, 450–455.[CrossRef]
    [Google Scholar]
  6. Rose W.E. , Schulz L.T. , Andes D. , Striker R. , Berti A.D. , Hutson P.R. , Shukla S.K. . ( 2012; ). Addition of ceftaroline to daptomycin after emergence of daptomycin‐nonsusceptible Staphylococcus aureus during therapy improves antibacterial activity. . Antimicrob Agents Chemother 56:, 5296–5302.[CrossRef]
    [Google Scholar]
  7. Sader H.S. , Flamm R.K. , Jones R.N. . ( 2013; ). Antimicrobial activity of ceftaroline tested against staphylococci with reduced susceptibility to linezolid, daptomycin, or vancomycin from U.S. hospitals, 2008 to 2011. . Antimicrob Agents Chemother 57:, 3178–3181.[CrossRef]
    [Google Scholar]
  8. Talbot G.H. , Bradley J. , Edwards J.E. Jr , Gilbert D. , Scheld M. , Bartlett J.G. . ( 2006; ). Bad bugs need drugs: an update on the development pipeline from the Antimicrobial Availability Task Force of the Infectious Diseases Society of America. . Clin Infect Dis 42:, 657–668.[CrossRef]
    [Google Scholar]
  9. van Hal S.J. , Fowler V.G. Jr . ( 2013; ). Is it time to replace vancomycin in the treatment of methicillin‐resistant Staphylococcus aureus infections?. . Clin Infect Dis 56:, 1779–1788.[CrossRef]
    [Google Scholar]
  10. Vidaillac C. , Leonard S.N. , Rybak M.J. . ( 2010; ). In vitro evaluation of ceftaroline alone and in combination with tobramycin against hospital‐acquired meticillin‐resistant Staphylococcus aureus (HA‐MRSA) isolates. . Int J Antimicrob Agents 35:, 527–530.[CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmmcr/10.1099/jmmcr.0.002394
Loading

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error