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Evolution of Antibiotic Tolerance During Oxacillin Daptomycin and Dalbavancin Therapy Results in Breakthrough Staphylococcus aureus Bacteremias

机译:奥沙西林达托霉素和达巴万星治疗过程中抗生素耐受性的演变导致突破性金黄色葡萄球菌细菌血症

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摘要

BackgroundClinicians can employ suppressive antimicrobial therapy in patients with persistent or relapsing bacteremia. However, bacteria with favorable susceptibility profiles may exhibit antimicrobial tolerance wherein bacteria cannot proliferate yet can survive in high concentrations of antibiotics. The antimicrobial tolerance phenotype can thwart efforts to prevent bacteremia recurrence with prolonged exposure to antimicrobials and may contribute to breakthrough bacteremias while the patient is receiving active therapy. Here we present a patient case consisting of multiple episodes of breakthrough Staphylococcus aureus bacteremia over several years in the setting of appropriately dosed antimicrobial suppressive therapy and describe organism mutations that developed during therapy.
机译:背景技术临床医生可对患有持续性或复发性菌血症的患者采用抑制性抗菌治疗。但是,具有良好敏感性的细菌可能会表现出抗菌耐受性,其中细菌无法增殖,但可以在高浓度的抗生素中存活。抗菌素耐受表型可能会阻止通过长时间接触抗菌素而防止菌血症复发的努力,并且可能在患者接受积极治疗时导致突破性菌血症。在这里,我们介绍了一个病人案例,该案例由适当剂量的抑菌治疗设定的多年中突破性金黄色葡萄球菌菌血症多次发作组成,并描述了在治疗过程中发生的机体突变。

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