Daptomycin-resistant Enterococcus faecium in a patient with acute myeloid leukemia.
case_report · Level V
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Abstract
Daptomycin is a lipopeptide antimicrobial used for the treatment of aerobic gram-positive skin and soft tissue infections. We describe a patient with acute myeloid leukemia whose febrile neutropenia was treated with daptomycin and who later developed daptomycin-resistant Enterococcus faecium infection. Defervescence and negative blood cultures ensued after treatment with linezolid. Guidelines for testing daptomycin susceptibillities of enterococci include breakpoints only for vancomycin-susceptible Enterococcus faecalis, making interpretation of minimum inhibitory concentrations for common clinical infections difficult. No enterococcal cross-resistance has been reported among daptomycin, linezolid, or quinupristin-dalfopristin, and these agents may be viable alternatives.
Medical subject headings
- Anti-Bacterial Agents
- Daptomycin
- Drug Resistance, Bacterial
- Enterococcus faecium
- Gram-Positive Bacterial Infections
- Leukemia, Myeloid