Title | Clinical impact of vancomycin heteroresistance in staphylococcal strains involved in neonatal sepsis: Discussion of a case report. | ||
Author | Butin, M; Claris, O; Laurent, F | ||
Journal | Arch Pediatr | Publication Year/Month | 2019-May |
PMID | 30954366 | PMCID | -N/A- |
Affiliation + expend | 1.Service de neonatologie et reanimation neonatale, hospices civils de Lyon, hopital femme-mere-enfant, 59, boulevard Pinel, 69677 Bron cedex, France; Equipe << Pathogenese des infections a Staphylocoques >>, Inserm U1111, centre international de recherche en infectiologie, 46, allee d'Italie, 69364 Lyon cedex 07, France. Electronic address: marine.butin@chu-lyon.fr. |
Heteroresistance to vancomycin (HRV) represents a decreased susceptibility to vancomycin and is frequently observed in multidrug-resistant coagulase-negative staphylococci. The clinical significance of such heteroresistance is controversial, but several failures of vancomycin therapy have been related to HRV, especially in the neonatal population. Here we report the case of a preterm neonate, born at 26 weeks of gestation, who developed sepsis due to a multidrug-resistant HRV Staphylococcuscapitis isolate. Bacteremia persisted despite adequate vancomycin serum concentration and catheter removal. The patient finally recovered after replacing vancomycin by linezolid. Through this case report, we would like to alert clinicians of the potential clinical impact of HRV and to discuss the lack of therapeutic alternatives in neonates.