Rapid emergence of daptomycin resistance in clinical isolates of Corynebacterium striatum… a cautionary tale

E. McElvania TeKippe, B. S. Thomas, G. A. Ewald, S. J. Lawrence, C. A D Burnham

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Abstract

The objective of this study was to investigate the observation of daptomycin resistance in Corynebacterium striatum, both in vivo and in vitro. We describe a case of C. striatum bacteremia in a patient with a left ventricular assist device (LVAD); the initial isolate recovered was daptomycin susceptible with a minimum inhibitory concentration (MIC) of 0.125 μg/ml. Two months later, and after daptomycin therapy, the individual became bacteremic with an isolate of C. striatum with a daptomycin MIC of >256 μg/ml. To study the prevalence of daptomycin resistance in C. striatum, clinical isolates of C. striatum were grown in broth culture containing daptomycin to investigate the emergence of resistance to this antimicrobial. Molecular typing was used to evaluate serial isolates from the index patient and the clinical isolates of C. striatum we assayed. In vitro analysis of isolates from the index patient and 7 of 11 additional C. striatum isolates exhibited the emergence of high-level daptomycin resistance, despite initially demonstrating low MICs to this antimicrobial agent. This phenotype was persistent even after serial subculture in the absence of daptomycin. Together, these data demonstrate that caution should be taken when using daptomycin to treat high-inoculum infections and/or infections of indwelling medical devices with C. striatum. To our knowledge, this is the first report characterizing the emergence of daptomycin resistance in C. striatum.

Original languageEnglish (US)
Pages (from-to)2199-2205
Number of pages7
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Volume33
Issue number12
DOIs
StatePublished - Nov 11 2014

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Daptomycin
Corynebacterium
Microbial Sensitivity Tests
Molecular Typing
Heart-Assist Devices
Bacteremia
Anti-Infective Agents
Infection
Cross-Sectional Studies
Observation

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Rapid emergence of daptomycin resistance in clinical isolates of Corynebacterium striatum… a cautionary tale. / McElvania TeKippe, E.; Thomas, B. S.; Ewald, G. A.; Lawrence, S. J.; Burnham, C. A D.

In: European Journal of Clinical Microbiology and Infectious Diseases, Vol. 33, No. 12, 11.11.2014, p. 2199-2205.

Research output: Contribution to journalArticle

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