Journal Article

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

Cesar A. Arias, Harrys A. Torres, Kavindra V. Singh, Diana Panesso, Judson Moore, Audrey Wanger and Barbara E. Murray

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 45, issue 10, pages 1343-1346
Published in print November 2007 | ISSN: 1058-4838
Published online November 2007 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/522656
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

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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.

Journal Article.  2198 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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