Rapid emergence of daptomycin resistance in clinical isolates of Corynebacterium striatum… a cautionary tale.
Rapid emergence of daptomycin resistance in clinical isolates of Corynebacterium striatum… a cautionary tale.
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DOI：
10.1007/s10096-014-2188-6
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发表时间：
2014-12
影响因子：
4.5
通讯作者：
Burnham, C. -A. D.
中科院分区：
文献类型：
--
作者：
TeKippe, E. McElvania;Thomas, B. S.;Ewald, G. A.;Lawrence, S. J.;Burnham, C. -A. D.
本研究的目的是调查观察达托霉素耐药性的棒状杆菌纹状体，在体内和体外。我们描述了一个C. 1例左心室辅助装置（LVAD）患者的纹状体菌血症;回收的初始分离株对达托霉素敏感，最小抑菌浓度（MIC）为0.125 μg/ml。两个月后，在达托霉素治疗后，该个体出现了菌血症，并分离出了C。达托霉素MIC>256 μg/ml。目的了解念珠菌对达托霉素的耐药情况。纹状体、临床分离的C.使纹状体在含有达托霉素肉汤培养物中生长，以研究对该抗微生物剂的抗性的出现。分子分型用于评估索引患者的系列分离株和临床分离株的C。纹状体我们分析。对索引患者和11个额外C中的7个分离株进行体外分析。纹状体分离株表现出高水平的达托霉素耐药性的出现，尽管最初表现出对这种抗菌剂的低MIC。这种表型是持久的，即使在连续传代培养达托霉素的情况下。总之，这些数据表明，在使用达托霉素治疗高接种量感染和/或留置医疗器械感染时应谨慎。纹状体据我们所知，这是第一个报告，描述了出现的达托霉素耐药性的C。纹状体
The objective of this study was to investigate the observation of daptomycin resistance in Corynebacterium striatum, both in vivo and in vitro. We describe a case of C. striatum bacteremia in a patient with a left ventricular assist device (LVAD); the initial isolate recovered was daptomycin susceptible with a minimum inhibitory concentration (MIC) of 0.125 μg/ml. Two months later, and after daptomycin therapy, the individual became bacteremic with an isolate of C. striatum with a daptomycin MIC of >256 μg/ml. To study the prevalence of daptomycin resistance in C. striatum, clinical isolates of C. striatum were grown in broth culture containing daptomycin to investigate emergence of resistance to this antimicrobial. Molecular typing was used to evaluate serial isolates from the index patient and the clinical isolates of C. striatum we assayed. In vitro analysis of isolates from the index patient and seven of eleven additional C. striatum isolates exhibited emergence of high level daptomycin resistance, despite initially demonstrating low MICs to this antimicrobial agent. This phenotype was persistent even after serial subculture in the absence of daptomycin. Together, these data demonstrate that caution should be taken when using daptomycin to treat high-inoculum infections and/or infections of indwelling medical devices with C. striatum. To our knowledge, this is the first report characterizing emergence of daptomycin resistance in C. striatum.
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