Infection and chemotherapy

The Korean Society of Infectious Diseases (대한감염학회)
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Alternating Linezolid-Vancomycin Therapy for Persistent Endovascular Methicillin-resistant Staphylococcus aureus Infection: A Case Report

리네졸리드와 반코마이신을 교대로 투여하여 치료한 지속성 메티실린 내성 황색포도알균 균혈증 1예

Kim, Nak-Hyun;Kim, Moon-Suk;Jang, Eun-Sun;Kang, Yu-Min;Kim, Ga-Yeon;Jang, Hee-Chang;Park, Wan-Beom;Kim, Eui-Chong;Kim, Nam-Joong;Oh, Myoung-Don
김낙현;김문석;장은선;강유민;김가연;장희창;박완범;김의종;김남중;오명돈

  • Published : 20091200
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Abstract

Persistent Staphylococcus aureus bacteremia is frequently defined as bacteremia persisting for ${\geq}$7 days despite proper antibiotic therapy. Its treatment includes removal of all infection foci and proper antibiotic therapy. Vancomycin remains the antibiotic of choice in MRSA bacteremia. Alternative agents, linezolid or daptomycin, are available, but a consensus regarding management of persistent MRSA bacteremia on vancomycin failure is still lacking. We report a case of a 60-year-old male who received thoracoabdominal aorta replacement operation due to dissecting aneurysm of the ascending and descending aorta. Surgical site infection and bacteremia caused by MRSA occured, and wound debridement operations were performed. The patient was treated with vancomycin in therapeutic doses but MRSA bacteremia persisted for 168 days in a row. Although the inserted aortic graft was the most probable source of persistent bacteremia, surgical removal was impossible. Linezolid was administered as an alternative antibiotic but had to be discontinued from time to time due to thrombocytopenia induced by this agent. In the end, MRSA bacteremia was successfully managed by alternating vancomycin-linezolid therapy.

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