A Patient with autoimmune hepatitis and transverse myelitis presented with persistent Staphylococcus aureus bacteremia, the discrepancies in assessing susceptibility; VISA versus Non-VISA

Authors

  • Jamal Ahmad Wadi Al Ramahi Office 11, The Medical Center, Jordan Hospital and medical Center 29 Adeeb Wahbeh Street Amman - Jordan 11118
  • Abdel Fattah Yacoub
  • Lamya Abu Shanab

DOI:

https://doi.org/10.3823/769

Keywords:

Vancomycin-intermediate S. aureus, VISA, S. aureus, Panton-Valentine-Leukocidin. Antimicrobial susceptibility testing

Abstract

Vancomycin-Intermediate Staphylococcus aureus (VISA) is still uncommon among MRSA isolates. In our region, we rarely encounter
a case of VISA and/or GISA bacteremia. Here, we report a man who suffered from autoimmune hepatitis on immunosuppressive therapy and thoracic transverse myelitis suspected to be due to polyomavirus infection; he developed persistent MRSA blood stream infection, PVL-positive and MLST clonal complex 88 which is reported most commonly from Africa. A strain with Vancomycin susceptibility of 4 – 6 µg/ml (VISA) was initially identifid, retested again elsewhere and showed MIC of 2µg/ml and Teicoplanin susceptibility of 4µg/ml. Treatment failure occurred while attaining higher serum vancomycin levels than recommended and died.

Author Biography

Jamal Ahmad Wadi Al Ramahi, Office 11, The Medical Center, Jordan Hospital and medical Center 29 Adeeb Wahbeh Street Amman - Jordan 11118

Chairman, The Infection Prevention and Control Committee

Al Khalidi Medical Center

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Published

2015-11-10

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