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Ceftaroline-Resistant, Daptomycin-Tolerant, and Heterogeneous Vancomycin-Intermediate Methicillin-Resistant Staphylococcus aureus Causing Infective Endocarditis.


ABSTRACT: We report a case of infective endocarditis (IE) caused by ceftaroline-resistant, daptomycin-tolerant, and heterogeneous vancomycin-intermediate methicillin-resistant S. aureus (MRSA). Resistance to ceftaroline emerged in the absence of drug exposure, and the E447K substitution in the active site of PBP2a previously associated with ceftaroline resistance was identified. Additionally, we present evidence of patient-to-patient transmission of the strain within the same unit. This case illustrates the difficulties in treating MRSA IE in the setting of a multidrug-resistant phenotype.

SUBMITTER: Nigo M 

PROVIDER: S-EPMC5328541 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

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Ceftaroline-Resistant, Daptomycin-Tolerant, and Heterogeneous Vancomycin-Intermediate Methicillin-Resistant Staphylococcus aureus Causing Infective Endocarditis.

Nigo Masayuki M   Diaz Lorena L   Carvajal Lina P LP   Tran Truc T TT   Rios Rafael R   Panesso Diana D   Garavito Juan D JD   Miller William R WR   Wanger Audrey A   Weinstock George G   Munita Jose M JM   Arias Cesar A CA   Chambers Henry F HF  

Antimicrobial agents and chemotherapy 20170223 3


We report a case of infective endocarditis (IE) caused by ceftaroline-resistant, daptomycin-tolerant, and heterogeneous vancomycin-intermediate methicillin-resistant <i>S. aureus</i> (MRSA). Resistance to ceftaroline emerged in the absence of drug exposure, and the E447K substitution in the active site of PBP2a previously associated with ceftaroline resistance was identified. Additionally, we present evidence of patient-to-patient transmission of the strain within the same unit. This case illust  ...[more]

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