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Endocarditis due to glycopeptide-intermediate Staphylococcus aureus: case report and strain characterization
Soraya Andrade-Baiocchi1, Maria Cristina B Tognim, Otavio C G Baiocchi
1Laboratório Especial de Microbiologia Clínica (LEMC), Division of Infectious Diseases, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
Diagnostic Microbiology and Infectious Disease
|March 5, 2003
Summary
Vancomycin-intermediate Staphylococcus aureus (VISA) caused infective endocarditis resistant to high-dose vancomycin. Clinical cure was achieved by adding linezolid to the treatment regimen.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Infective endocarditis is a serious infection of the heart lining.
- Staphylococcus aureus is a common cause of infective endocarditis.
- Vancomycin is a primary antibiotic for treating Staphylococcus aureus infections, but resistance is a growing concern.
Observation:
- A patient presented with infective endocarditis caused by vancomycin-intermediate Staphylococcus aureus (VISA).
- The VISA strain showed an initial vancomycin Minimum Inhibitory Concentration (MIC) of 8 µg/mL, inducible to 32 µg/mL.
- High-dose vancomycin therapy failed to achieve a clinical response.
Findings:
- The VISA isolate demonstrated inducible vancomycin resistance.
- Treatment escalation was necessary due to vancomycin treatment failure.
- Successful clinical outcome was achieved with the addition of linezolid.
Implications:
- This case highlights the challenge of treating VISA infections.
- Linezolid can be an effective alternative or adjunctive therapy for vancomycin-resistant Staphylococcus aureus.
- Monitoring vancomycin MIC and considering alternative agents are crucial for managing complex endocarditis cases.