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Volume 18, Number 4—April 2012


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

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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.

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