Life-threatening infection caused by daptomycin-resistant Corynebacterium jeikeium in a neutropenic patient

Abstract

Daptomycin is a novel lipopeptide antibiotic agent approved for the treatment of gram-positive life-threatening infections. Here we report, for the first time, the isolation of a highly daptomycin-resistant strain of Corynebacterium jeikeium causing a life-threatening infection in a neutropenic patient undergoing cord blood transplantation for secondary acute myeloid leukemia.

FIG. 1.

Schematic diagram of clinical course at transplant. Ratios in parentheses show the number of cultures positive for the indicated organism versus the number tested. Dosing of antibiotic drugs was as follows: ceftazidime, 2 g intravenously (i.v.) three times daily; tigecycline, 50 mg i.v. twice daily after 100 mg i.v. as a loading dose; meropenem, 1 g i.v. three times daily; fosfomycin, 3 g i.v. three times daily; daptomycin, 500 mg i.v. once daily for three days [7.5 mg/kg of body weight] followed by 350 mg i.v. once daily [5 mg/kg]; ciprofloxacin, 500 mg orally and 400 mg i.v., respectively, twice daily; vancomycin, 1 g i.v. twice daily with pharmacomonitoring. *, Antifungal therapy included one of the following: voriconazole, caspofungin, posaconazole, or liposomal amphotericin B. Abbreviations: WBC, white blood cell count; NR, normal range; L, liter.