Vertebral osteomyelitis caused by vancomycin-tolerant methicillin-resistant Staphylococcus aureus bacteremia: Experience with teicoplanin plus fosfomycin combination therapy

Wen Sen Lee, Yen Chuo Chen, Hung Ping Chen, Tso Hsiao Chen, Chung Yi Cheng

研究成果: 雜誌貢獻文章

4 引文 斯高帕斯(Scopus)


An 85-year-old female presented with fever and consciousness disturbance for 3 days. The patient's blood culture subsequently revealed persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia despite the administration of vancomycin or teicoplanin monotherapy. Gallium inflammation scan and magnetic resonance image of the spine disclosed osteomyelitis and discitis at the level of L4-5. Surgical debridement was not feasible in this debilitated patient. Because of the creeping minimal inhibitory concentration of vancomycin of the causative isolate (1.5 μg/mL) and clinical failure with glycopeptide monotherapy, we changed the antibiotic therapy to a fosfomycin and teicoplanin combination therapy. The patient showed improved clinical response in terms of her enhanced consciousness as well as subsidence of persisted bacteremia. Despite the potential side effects of fosfomycin (such as diarrhea and hypernatremia), it combined with a glycopeptide may be an alternative therapy for invasive refractory MRSA infections.
期刊Journal of Microbiology, Immunology and Infection
出版狀態已發佈 - 八月 1 2016


ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Immunology and Allergy
  • Immunology and Microbiology(all)