Disseminated Community-Acquired USA300 Methicillin-Resistant<i>Staphylococcus aureus</i>Pyomyositis and Septic Pulmonary Emboli in an Immunocompetent Adult

Woodward, Joseph F.; SenGupta, Dhruba J.; Cookson, Brad T.; Park, James O.; Dellinger, E. Patchen

doi:10.1089/sur.2009.015

Cited by 8 publications

(4 citation statements)

References 29 publications

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“…The sequences were translated to spa types according to Ridom and Kreisworth conventions [11]. Variable tandem nucleotide repeat (VNTR) typing was performed as described previously [12,13].…”

Section: Strain Typingmentioning

confidence: 99%

Emergence of dalbavancin non-susceptible, vancomycin-intermediate Staphylococcus aureus (VISA) after treatment of MRSA central line-associated bloodstream infection with a dalbavancin- and vancomycin-containing regimen

Werth

Jain

Hahn

et al. 2018

Clinical Microbiology and Infection

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Objectives: Dalbavancin is a long-acting lipoglycopeptide with activity against gram-positives, including methicillin-resistant Staphylococcus aureus (MRSA). The potential for lipoglycopeptides, with half-lives greater than 1 week, to select for resistance is unknown. Here we explore a case of MRSA central lineassociated bloodstream infection in which dalbavancin and vancomycin non-susceptibility emerged in a urine isolate collected after the patient was treated with vancomycin and dalbavancin sequentially. Methods: Isolates from blood and urine underwent susceptibility testing, and whole genome sequencing (WGS). The blood isolate was subjected to successive passage in vitro in the presence of escalating dalbavancin concentrations and the emergent isolate was subjected to repeat susceptibility testing and WGS. Results: The blood isolate was fully susceptible to vancomycin; however, MICs of the urine isolate to dalbavancin, vancomycin, telavancin, and daptomycin were at least fourfold higher than the bloodderived strain. Both strains were indistinguishable by spa and variable number tandem repeat (VNTR) typing, and WGS revealed only seven variants, indicating clonality. Four variants affected genes, including a 3bp in-frame deletion in yvqF, a gene which has been implicated in glycopeptide resistance. Vancomycin and dalbavancin non-susceptibility emerged in the blood isolate after successive passage in vitro in the presence of dalbavancin, and WGS identified a single non-synonymous variant in yvqF. Conclusions: This is the first case in which VISA has emerged in the context of a dalbavancin-containing regimen. The selection for cross-resistance to vancomycin in vitro by dalbavancin exposure alone is troubling. Clinicians should be aware of the possibility for emergence of dalbavancin non-susceptibility and glycopeptide cross-resistance arising following therapy.

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Section: Strain Typingmentioning

confidence: 99%

Emergence of dalbavancin non-susceptible, vancomycin-intermediate Staphylococcus aureus (VISA) after treatment of MRSA central line-associated bloodstream infection with a dalbavancin- and vancomycin-containing regimen

Werth

Jain

Hahn

et al. 2018

Clinical Microbiology and Infection

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“…6 S. aureus is the most common pathogen isolated in up to 90% from blood cultures or surgical specimens. 7 Other bacteria implicated are S. pyogenes, S. pneumoniae, Neisseria spp. and Aeromonas spp., among others.…”

Section: Discussionmentioning

confidence: 99%

Septic emboli from pyomyositis

et al. 2020

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Pyomyositis commonly presents with fever, muscle pain and abscess formation involving deep soft-tissue compartments. Staphylococcus aureus is the main causative organism and diagnosis is usually established clinically, supported by imaging, but confirmation may be achieved by histopathological examination. Broad-spectrum antibiotic therapy and surgical debridement are the cornerstone of treatment. Its prognosis is good but, as in all soft-tissue infections, it depends on early intervention, directed antibiotics and, if indicated, prompt surgery. In this paper, we describe a case of pelvic pyomyositis complicated with bacteraemia and bilateral septic pulmonary emboli in a young man in Colombia.

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“…[2][3][4] Recently, septic pulmonary emboli arising from primary deep tissue infections such as pyomyositis, cellulitis, osteomyelitis, prostatic and periproctal abscess have been described in the adult population. [8][9][10][11][12][13] A recent systematic review of 76 articles consisting of a total 168 cases by Ye et al 14 in 2014 showed that major risk factors for SPE were intravenous drug use, intravascular indwelling catheter and skin or soft tissue purulent infection. Seventeen cases died and 101 cases were cured.…”

Section: Discussionmentioning

confidence: 99%

Disseminated Staphylococcal Infection in an Immunocompetent Adult: A Case Report

Cruz¹,

Tan²

2016

Acta Med Philipp

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Disseminated Community-Acquired USA300 Methicillin-ResistantStaphylococcus aureusPyomyositis and Septic Pulmonary Emboli in an Immunocompetent Adult

Abstract: The clinical history and management of severe disseminated pyomyositis, including diagnostic modalities, antimicrobial therapy, and surgical drainage, require an aggressive approach.

Cited by 8 publications

References 29 publications

Emergence of dalbavancin non-susceptible, vancomycin-intermediate Staphylococcus aureus (VISA) after treatment of MRSA central line-associated bloodstream infection with a dalbavancin- and vancomycin-containing regimen

Emergence of dalbavancin non-susceptible, vancomycin-intermediate Staphylococcus aureus (VISA) after treatment of MRSA central line-associated bloodstream infection with a dalbavancin- and vancomycin-containing regimen

Septic emboli from pyomyositis

Disseminated Staphylococcal Infection in an Immunocompetent Adult: A Case Report

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