Endocarditis Case Report: Treatment Failure with Vancomycin
Author Information
Author(s): Beatriz Perazzi, Natalia Bello, Marta Mollerach, Carlos Vay, María Beatriz Lasala, Angela Famiglietti
Primary Institution: University of Buenos Aires
Hypothesis
Can methicillin-susceptible Staphylococcus aureus with reduced susceptibility to vancomycin lead to treatment failure?
Conclusion
The case highlights the existence of subpopulations of methicillin-susceptible Staphylococcus aureus that have reduced susceptibility to vancomycin, which can result in treatment failure.
Supporting Evidence
- The patient initially treated with cephalothin and gentamicin developed a rash and interstitial nephritis.
- Vancomycin treatment failed initially but was later combined with gentamicin and rifampin, leading to resolution of the infection.
- The vancomycin MIC for the isolates was determined to be 1 μg/mL, indicating reduced susceptibility.
Takeaway
A man got sick from a type of bacteria that didn't get better with a common medicine called vancomycin because some of the bacteria were a bit stronger than usual.
Methodology
The case involved a 66-year-old man treated with various antibiotics, including vancomycin, and monitored through blood cultures and echocardiograms.
Limitations
The study is based on a single case report, limiting generalizability.
Participant Demographics
66-year-old Hispanic man with a history of diabetes and other health issues.
Digital Object Identifier (DOI)
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