Resistance to Daptomycin in the Treatment of Methicillin Resistant Staphylococcus aureus Bacteremia
Abstract
Staphylococcus aureus is an aerobic gram positive bacterium that can cause
harmful skin infections and bacteremia. Some strains of S. aureus have become resistant
to synthetic penicillin (Methicillin) and therefore need to be treated with Daptomycin
(Skiest 2006). Daptomycin is a novellipopeptide antibiotic that was approved by the
Food and Drug Administration (FDA) for treatment of gram positive skin infections in
2003 (Hayden et al. 2005 and Marty et al. 2006). Daptomycin has been known to
successfully combat gram-positive bacteria by quickly depolarizing the cells. Two
patients at St. John Hospital & Medical Center (Detroit, MI) were on prolonged treatment
of Daptomycin for S. aureus bacteremia and blood cultures showed non-susceptibility to
the drug. The samples from these patients were collected and saved so that nonsusceptibility
to Daptomycin treatment could be tracked over time using a microdilution
technique to determine minimum inhibitory concentrations (MI Cs) of the drug. Using
SCCmec typing and Pulsed Field Gel Electrophoresis (PFGE), strains of bacteria were
compared and classified. Both patients' blood cultures were shown to develop nonsusceptibility
to Daptomycin after 5 and 7 days of treatment. Clinically, this study shows
that patients with S. aureus bacteremia treated with Daptomycin for prolonged periods of
time should have their samples carefully monitored for non-susceptibility that may lead
to failure of treatment.
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