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A case of fatal daptomycin-resistant, vancomycinresistantenterococcal infective endocarditis in end-stage kidney disease

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Show simple item record O'Connor, Ciara Casserly, Liam F. Qazi, Junaid Power, Lorraine Finnegan, Cathriona O'Connell, Nuala H. Dunne, Colum P. 2015-11-16T14:58:57Z 2015-11-16T14:58:57Z 2015
dc.description peer-reviewed en_US
dc.description.abstract Introduction: Ireland currently has the highest reported rate in Europe of vancomycin-resistant Enterococcus (VRE) isolated from the bloodstream, but data regarding the prevalence of VRE endocarditis remain scarce. Treatment options for Enterococcus-mediated endocarditis are limited, and therefore daptomycin is commonly used off licence in this setting. Case presentation: A 60-year-old male with end-stage kidney disease (ESKD) presented with VRE bacteraemia secondary to a gangrenous right foot colonized with vancomycin-resistant Enterococcus faecium. Aortic valve endocarditis was confirmed using transoesophageal echocardiography. Treatment was commenced with linezolid and subsequently modified to combination therapy with daptomycin and rifampicin. High-dose daptomycin therapy was employed unsuccessfully and, after 20 days of therapy, daptomycin resistance emerged, which proved fatal. Conclusion: The case was ethically challenging and involved a refusal of amputation and, ultimately, any form of treatment by the patient. In summary, however, daptomycin-resistant VRE bacteraemia complicated by recalcitrant daptomycin-resistant VRE endocarditis proved fatal for this patient. Further evaluation of the efficacy and safety of high-dose daptomycin for the treatment of VRE infective endocarditis is needed. en_US
dc.language.iso eng en_US
dc.publisher Society for General Microbiology en_US
dc.subject daptomycin en_US
dc.subject end-stage kidney disease (ESKD) en_US
dc.subject resistance en_US
dc.subject rifampicin en_US
dc.title A case of fatal daptomycin-resistant, vancomycinresistantenterococcal infective endocarditis in end-stage kidney disease en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.identifier.doi 10.1099/jmmcr.0.000089
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US
dc.internal.rssid 1593590

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