Ceftaroline-resistant, daptomycin-tolerant, and heterogeneous vancomycin-intermediate methicillin-resistant Staphylococcus aureus causing infective endocarditis

Masayuki Nigo; Lorena Diaz; Lina P. Carvajal; Truc T. Tran; Rafael Rios; Diana Panesso; Juan D. Garavito; William R. Miller; Audrey Wanger; George Weinstock; Jose M. Munita; Cesar A. Arias; Henry F. Chambers

doi:10.1128/AAC.01235-16

Ceftaroline-resistant, daptomycin-tolerant, and heterogeneous vancomycin-intermediate methicillin-resistant Staphylococcus aureus causing infective endocarditis

Masayuki Nigo, Lorena Diaz, Lina P. Carvajal, Truc T. Tran, Rafael Rios, Diana Panesso, Juan D. Garavito, William R. Miller, Audrey Wanger, George Weinstock, Jose M. Munita, Cesar A. Arias, Henry F. Chambers

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28 Scopus citations

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.

Original language	English (US)
Article number	e01235
Journal	Antimicrobial Agents and Chemotherapy
Volume	61
Issue number	3
DOIs	https://doi.org/10.1128/AAC.01235-16
State	Published - Mar 1 2017

Keywords

Ceftaroline
Endocarditis
Staphylococcus aureus

ASJC Scopus subject areas

Pharmacology
Pharmacology (medical)
Infectious Diseases

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10.1128/AAC.01235-16

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Nigo, M., Diaz, L., Carvajal, L. P., Tran, T. T., Rios, R., Panesso, D., Garavito, J. D., Miller, W. R., Wanger, A., Weinstock, G., Munita, J. M., Arias, C. A., & Chambers, H. F. (2017). Ceftaroline-resistant, daptomycin-tolerant, and heterogeneous vancomycin-intermediate methicillin-resistant Staphylococcus aureus causing infective endocarditis. Antimicrobial Agents and Chemotherapy, 61(3), Article e01235. https://doi.org/10.1128/AAC.01235-16

Nigo, M, Diaz, L, Carvajal, LP, Tran, TT, Rios, R, Panesso, D, Garavito, JD, Miller, WR, Wanger, A, Weinstock, G, Munita, JM, Arias, CA & Chambers, HF 2017, 'Ceftaroline-resistant, daptomycin-tolerant, and heterogeneous vancomycin-intermediate methicillin-resistant Staphylococcus aureus causing infective endocarditis', Antimicrobial Agents and Chemotherapy, vol. 61, no. 3, e01235. https://doi.org/10.1128/AAC.01235-16

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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.",

keywords = "Ceftaroline, Endocarditis, Staphylococcus aureus",

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AU - Carvajal, Lina P.

AU - Tran, Truc T.

AU - Rios, Rafael

AU - Panesso, Diana

AU - Garavito, Juan D.

AU - Miller, William R.

AU - Wanger, Audrey

AU - Weinstock, George

AU - Munita, Jose M.

AU - Arias, Cesar A.

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AB - 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.

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Ceftaroline-resistant, daptomycin-tolerant, and heterogeneous vancomycin-intermediate methicillin-resistant Staphylococcus aureus causing infective endocarditis

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