达巴万星治疗耐甲氧西林金黄色葡萄球菌心内膜炎失败
Unsuccessful treatment of methicillin-resistant Staphylococcus aureus endocarditis with dalbavancin.
作者信息
Steele J M, Seabury R W, Hale C M, Mogle B T
机构信息
Department of Pharmacy, State University of New York Upstate Medical University - University Hospital, Syracuse, NY, USA.
Department of Medicine, State University of New York Upstate Medical University, Syracuse, NY, USA.
出版信息
J Clin Pharm Ther. 2018 Feb;43(1):101-103. doi: 10.1111/jcpt.12580. Epub 2017 Jun 19.
WHAT IS KNOWN AND OBJECTIVE
Limited evidence describes dalbavancin use in infective endocarditis (IE).
CASE DESCRIPTION
A 27-year-old pregnant female received 4 weeks of dalbavancin for methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia and tricuspid valve IE after conventional therapy was no longer an option due to non-compliance. Despite having a smaller cardiac vegetation following dalbavancin, she was bacteraemic <2 weeks later with vancomycin-intermediate (VISA) and telavancin-non-susceptible S. aureus.
WHAT IS NEW AND CONCLUSION
This is the first report of unsuccessful IE treatment with dalbavancin. Blood cultures grew VISA and lipoglycopeptide-non-susceptible S. aureus <2 weeks following dalbavancin. Both outcomes raise concerns about using dalbavancin for IE.
已知信息与目的
关于达巴万星用于感染性心内膜炎（IE）的证据有限。
病例描述
一名27岁的孕妇因耐甲氧西林金黄色葡萄球菌（MRSA）菌血症和三尖瓣IE接受了4周的达巴万星治疗，此前由于患者不依从，常规治疗已不再可行。尽管使用达巴万星后心脏赘生物变小，但她在2周内再次出现菌血症，血培养出万古霉素中介（VISA）且对替考拉宁不敏感的金黄色葡萄球菌。
新发现与结论
这是首例使用达巴万星治疗IE失败的报告。使用达巴万星后不到2周，血培养出VISA和对脂糖肽不敏感的金黄色葡萄球菌。这两个结果都引发了对使用达巴万星治疗IE的担忧。
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