Emergence of Dalbavancin, Vancomycin, and Daptomycin Nonsusceptible <i>Staphylococcus aureus</i> in a Patient Treated With Dalbavancin: Case Report and Isolate Characterization
Rutan Zhang, Hari Polenakovik, Ismael A Barreras Beltran, Adam Waalkes, Stephen J. Salipante, Libin Xu, Brian J. Werth
Abstract
A patient with end-stage renal disease received 2 doses of dalbavancin for methicillin-resistant Staphylococcus aureus (MRSA) arteriovenous fistula infection and presented 5 weeks later with infective endocarditis secondary to vancomycin, daptomycin, and dalbavancin nonsusceptible MRSA. Resistance was associated with walK and scrA mutations, reduced long-chain lipid content, and reduced membrane fluidity.
Topics & Concepts
DalbavancinDaptomycinMedicineStaphylococcus aureusVancomycinMicrobiologyMethicillin-resistant Staphylococcus aureusBacteremiaEndocarditisTeicoplaninInfective endocarditisStaphylococcal infectionsAntibioticsSurgeryBacteriaBiologyGeneticsAntimicrobial Resistance in StaphylococcusInfective Endocarditis Diagnosis and ManagementBacterial Identification and Susceptibility Testing