Emergence of Dalbavancin, Vancomycin, and Daptomycin Nonsusceptible Staphylococcus aureus in a Patient Treated With Dalbavancin: Case Report and Isolate Characterization.
Rutan Zhang, Hari Polenakovik, Ismael A Barreras Beltran, Adam Waalkes, Stephen J Salipante, Libin Xu, Brian J Werth
Author Information
Rutan Zhang: Department of Medicinal Chemistry, University of Washington School of Pharmacy, Seattle, Washington, USA.
Hari Polenakovik: Veterans Affairs Medical Center, Dayton, Ohio, USA.
Ismael A Barreras Beltran: Department of Pharmacy, University of Washington School of Pharmacy, Seattle, Washington, USA.
Adam Waalkes: Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA.
Stephen J Salipante: Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA.
Libin Xu: Department of Medicinal Chemistry, University of Washington School of Pharmacy, Seattle, Washington, USA.
Brian J Werth: Department of Pharmacy, University of Washington School of Pharmacy, Seattle, Washington, USA. ORCID
A patient with end-stage renal disease received 2 doses of dalbavancin for methicillin-resistant Staphylococcus aureus (MRSA) arteriovenous fistula infection and presented 5 weeks later with infective endocarditis secondary to vancomycin, daptomycin, and dalbavancin nonsusceptible MRSA. Resistance was associated with walK and scrA mutations, reduced long-chain lipid content, and reduced membrane fluidity.
