Distinct Subpopulations of Intravalvular Methicillin-Resistant Staphylococcus aureus with Variable Susceptibility to Daptomycin in Tricuspid Valve Endocarditis.

Christopher R Miller, Somrita Dey, Paula D Smolenski, Pushkar S Kulkarni, Jonathan M Monk, Richard Szubin, George Sakoulas, Andrew D Berti

Antimicrobial agents and chemotherapy 2020 Feb 21

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We present a case of endocarditis wherein organisms cultured from different valve leaflets yielded different daptomycin susceptibilities from each other and from organisms obtained from peripheral blood culture. Genomic analyses showed mutations in mprF, purR, and agrA Pharmacokinetic simulations showed consistent activity of daptomycin plus beta-lactam against all subpopulations. This represents an opportunity to understand S. aureus evolution and fitness in vivo on daptomycin therapy and the role of beta-lactams to prevent the selection of daptomycin-resistant subpopulations. Copyright © 2020 American Society for Microbiology.

Citation

Christopher R Miller, Somrita Dey, Paula D Smolenski, Pushkar S Kulkarni, Jonathan M Monk, Richard Szubin, George Sakoulas, Andrew D Berti. Distinct Subpopulations of Intravalvular Methicillin-Resistant Staphylococcus aureus with Variable Susceptibility to Daptomycin in Tricuspid Valve Endocarditis. Antimicrobial agents and chemotherapy. 2020 Feb 21;64(3)