A Patient with autoimmune hepatitis and transverse myelitis presented with persistent Staphylococcus aureus bacteremia, the discrepancies in assessing susceptibility; VISA versus Non-VISA
Keywords:Vancomycin-intermediate S. aureus, VISA, S. aureus, Panton-Valentine-Leukocidin. Antimicrobial susceptibility testing
Vancomycin-Intermediate Staphylococcus aureus (VISA) is stillÂ uncommon among MRSA isolates. In our region, we rarely encounter
a case of VISA and/or GISA bacteremia. Here, we report a man whoÂ suffered from autoimmune hepatitis on immunosuppressive therapyÂ and thoracic transverse myelitis suspected to be due to polyomavirusÂ infection; he developed persistent MRSA blood stream infection,Â PVL-positive and MLST clonal complex 88 which is reported mostÂ commonly from Africa. A strain with Vancomycin susceptibility ofÂ 4 â€“ 6 Âµg/ml (VISA) was initially identifid, retested again elsewhereÂ and showed MIC of 2Âµg/ml and Teicoplanin susceptibility of 4Âµg/ml.Â Treatment failure occurred while attaining higher serum vancomycinÂ levels than recommended and died.
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access and Benefits of Publishing Open Access).
This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge.
Articles are published Under License of Creative Commons Attribution 3.0 License Â©
Copyright policies & self-archiving
|Author's Pre-print:||author can archive pre-print (ie pre-refereeing)|
|Author's Post-print:||author can archive post-print (ie final draft post-refereeing)|
|Publisher's Version/PDF:||author can archive publisher's version/PDF|