First isolation in Argentina of community-acquired methicillin-resistant Staphylococcus aureus with intermediate susceptibility to vancomycin and non-susceptibility to daptomycin

We report the first case in Argentina of community-acquired methicillin-resistant Staphylococcus aureus with intermediate susceptibility to vancomycin and non-susceptibility to daptomycin. Case report: A male patient with a history of chronic renal failure on hemodialysis and hip fracture osteosynthesis was admitted to hospital for persistent febrile syndrome following the displacement of the prosthesis by trauma. Blood cultures grew community-acquired methicillin-resistant Staphylococcus aureus. During treatment with vancomycin and daptomycin, a gradual increase in vancomycin MIC of 1 mu g/ml (VSSA) to 2 mu g/ml (h-VISA) and 4 mu g/ml (VISA) was observed, as well as the emergence of non-susceptibility to daptomycin (MIC = 4 mu g/ml). By suspending vancomycin and daptomycin, the strain reversed to the susceptible phenotype to both drugs. It is mandatory to evaluate by MIC the susceptibility to vancomycin and daptomycin during treatment when these drugs are used as therapy. (C) 2013 Asociacion Argentina de Microbiologia. Publicado par Elsevier Espana, S.L. Todos Los derechos reservados.