Failure of Daptomycin Monotherapy for Endocarditis Caused by an Enterococcus faecium Strain with Vancomycin-Resistant and Vancomycin-Susceptible Subpopulations and Evidence of In Vivo Loss of the vanA Gene Cluster | Zendy

César A. Arias | Zendy; Harrys A. Torres | Zendy; Kavindra V. Singh | Zendy; Diana Panesso | Zendy; John E. Moore | Zendy; Audrey Wanger | Zendy; Barbara E. Murray | Zendy

Open Access

Failure of Daptomycin Monotherapy for Endocarditis Caused by an Enterococcus faecium Strain with Vancomycin-Resistant and Vancomycin-Susceptible Subpopulations and Evidence of In Vivo Loss of the vanA Gene Cluster

Author(s) -

César A. Arias,

Harrys A. Torres,

Kavindra V. Singh,

Diana Panesso,

John E. Moore,

Audrey Wanger,

Barbara E. Murray

Publication year - 2007

Publication title -

clinical infectious diseases

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 3.44

H-Index - 336

eISSN - 1537-6591

pISSN - 1058-4838

DOI - 10.1086/522656

Subject(s) - daptomycin , vancomycin , medicine , enterococcus faecium , endocarditis , microbiology and biotechnology , enterococcus , gentamicin , ampicillin , antibiotics , bacteremia , antibacterial agent , in vivo , staphylococcus aureus , biology , bacteria , genetics

A patient with native valve endocarditis caused by a vancomycin "heteroresistant" strain of Enterococcus faecium experienced failure of daptomycin monotherapy without evidence of daptomycin resistance. The infecting organism exhibited in vivo emergence of a vancomycin-susceptible subpopulation lacking vanA. Treatment with a combination of high-dose daptomycin, gentamicin, and high-dose ampicillin cleared the infection.

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