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Volume 18, Number 4—April 2012
Dispatch

De Novo Daptomycin-Nonsusceptible Enterococcal Infections

Theodoros KelesidisComments to Author , Romney Humphries, Daniel Z. Uslan, and David Pegues
Author affiliations: David Geffen School of Medicine at UCLA, Los Angeles, California, USA

Main Article

Table 1

Patient and treatment characteristics for 9 patients with DNSE infection and colonization, Los Angeles, California, USA, 2007–2011*

Patient no., age, y/sex Concurrent conditions† Recent surgery Site of isolation Enterococcus species Hospital day of DNSE isolation Source of Enterococcus infection Other pathogens isolated at DNSE site Tx Outcome of Enterococcus infection
1/69/M RA on steroids, CHF, s/p AVR, s/p CABG BKA, vascular surgery Blood E. faecium 47 CLABSI None DAP Death
2/70/M Diabetes, bowel disease, ILD on steroids, lung transplant Thoracic Blood, pleural fluid empyema E. faecium 75 CLABSI, empyema None LZD, Q-D, GEN Death
3/51/M Colitis, TCC, severe hypocalcemia No Blood E. faecium 17 CLABSI None VAN Death
4/53/F CNS tumor No Urine E. faecalis 1 Asymptomatic bacteriuria None None Undetermined
5/75/M CVA No Urine E. faecalis 1 UTI None LZD, VAN Recovered
6/62/M AIDS Soft tissue Wound E. faecium 23 Chronic decubitus ulcerations E. coli, MRSA, Candida spp. LZD Undetermined
7/64/F Diabetes, bowel disease, splenectomy GI tract Abscess E. gallinarum 1 Intra-abdominal abscess Anaerobes, S. viridans PIP/TAZ, ERT Recovered
8/26/F Cirrhosis, ESRD, breast cancer GI tract Abscess E. faecium 65 Liver abscess E. coli, Klebsiella spp., Stenotro. LZD Death
9/60/M Diabetes, pancreatic cancer No Bile E. faecium 1 Cholangitis Fungi (C. glabrata, A. fumigatus, S. cerevisiae) PIP/TAZ Undetermined

*DNSE, daptomycin-nonsusceptible enterococcus; Tx, treatment; RA, rheumatoid arthritis; CHF, congestive heart failure; AVR, aortic valve replacement; CABG, coronary artery bypass graft; BKA, below knee amputation; CLABSI, central line–associated bloodstream infection; DAP, daptomycin; ILD, interstitial lung disease; LZD, linezolid; Q-D, quinupristin/dalfopristin; GEN, gentamicin; TCC, transitional cell carcinoma; VAN, vancomycin; CNS, central nervous system; CVA, cerebrovascular accident; UTI, urinary tract infection; E. coli, Escherichia coli ; MRSA, methicillin-resistant Staphylococcus aureus; GI, gastrointestinal; S. viridans, Streptococcus viridans; PIP/TAZ, piperacillin/tazobactam;ESRD, end-stage renal disease; Stenotro., Stenotrophomonas; C. glabrata, Candida glabrata; A. fumigatus, Aspergillus fumigatus; S. cerevisiae, Saccharomyces cerevisiae
†Bowel disease was defined as presence of colitis, ischemic colitis, colonic ulcers, obstruction, or bowel surgery within 3 mo.

Main Article

Page created: March 14, 2012
Page updated: March 14, 2012
Page reviewed: March 14, 2012
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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