Left ventricular assist device-associated endocarditis involving multiple clones of Staphylococcus aureus with distinct antimicrobial susceptibility patterns

Sohei Harada; Kotaro Aoki; Koh Okamoto; Osamu Kinoshita; Kan Nawata; Yoshikazu Ishii; Kazuhiro Tateda; Masakazu Sasaki; Tomoo Saga; Yohei Doi; Hiroshi Yotsuyanagi; Kyoji Moriya; Minoru Ono

doi:10.1016/j.ijid.2019.05.001

Left ventricular assist device-associated endocarditis involving multiple clones of Staphylococcus aureus with distinct antimicrobial susceptibility patterns

Int J Infect Dis. 2019 Jul:84:44-47. doi: 10.1016/j.ijid.2019.05.001. Epub 2019 May 7.

Authors

Affiliations

¹ Department of Infectious Diseases, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan; Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan. Electronic address: haradas-tky@umin.ac.jp.
² Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan.
³ Department of Infectious Diseases, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
⁴ Department of Cardiac Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
⁵ Department of Clinical Laboratories, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan.
⁶ Central Laboratory Division, Akita University Hospital, 1-1-1 Hondo, Akita 010-8543, Japan.
⁷ Department of Infectious Diseases, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan.

PMID: 31075509
DOI: 10.1016/j.ijid.2019.05.001

Abstract

The case of a patient with left ventricular assist device (LVAD)-associated endocarditis involving multiple clones of Staphylococcus aureus is presented. Different clones with distinct colony morphology were identified from blood cultures collected on the same day and showed diverse antimicrobial resistance patterns. In addition, a difference in antimicrobial susceptibility was observed even within an identical clone recovered 400 days apart due to the loss of SCCmec for methicillin and modification of the 23S rRNA target site for linezolid during a long-term treatment course.

Keywords: Endocarditis; Left ventricular assist device; Linezolid resistance; Staphylococcus aureus; Whole-genome sequencing.

Publication types

Case Reports

MeSH terms

Anti-Bacterial Agents / pharmacology*
Anti-Bacterial Agents / therapeutic use
Endocarditis, Bacterial / drug therapy
Endocarditis, Bacterial / etiology*
Endocarditis, Bacterial / microbiology
Heart Ventricles*
Heart-Assist Devices / adverse effects*
Humans
Linezolid / therapeutic use
Male
Methicillin-Resistant Staphylococcus aureus / genetics
Microbial Sensitivity Tests
Middle Aged
RNA, Ribosomal, 23S
Staphylococcal Infections / drug therapy
Staphylococcal Infections / etiology*
Staphylococcal Infections / microbiology
Staphylococcus aureus* / drug effects
Staphylococcus aureus* / genetics

Substances

Anti-Bacterial Agents
RNA, Ribosomal, 23S
Linezolid