Relapse of Type a β-Lactamase-Producing Staphylococcus aureus Native Valve Endocarditis during Cefazolin Therapy: Revisiting the Issue

Esteban C. Nannini, Kavindra V. Singh, Barbara E. Murray

Research output: Contribution to journalArticlepeer-review

Abstract

Our experience with a patient with methicillin-susceptible Staphylococcus aureus aortic native valve endocarditis, who had a relapse involving fever and positive blood culture results while receiving cefazolin, led us to evaluate this organism's ability to hydrolyze cefazolin at high inocula, a previously well-documented phenomenon. Analysis of the infecting strain disclosed a high minimum inhibitory concentration of cefazolin when a large inoculum was used, as well as rapid and complete cefazolin degradation, which was associated with regrowth in a time-kill experiment. DNA sequencing of the β-lactamase gene showed that it was identical to that of the S. aureus type A β-lactamase, known to efficiently inactivate cefazolin. A word of caution is given regarding the use of this antibiotic for treatment of endocarditis caused by this type of S. aureus isolate.

Original languageEnglish (US)
Pages (from-to)1194-1198
Number of pages5
JournalClinical Infectious Diseases
Volume37
Issue number9
DOIs
StatePublished - Nov 1 2003

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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