Failure of mecA/mecC PCR Testing to Accurately Predict Oxacillin Resistance in a Patient with Staphylococcus aureus Infective Endocarditis

Genotypic testing for / is heavily relied upon for rapid optimization of antimicrobial therapy in infections due to Staphylococcus aureus. Little is known regarding optimal reporting and/or therapy for patients demonstrating lack of genotypic evidence of or but phenotypic oxacillin resistance. We re...

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Published inAntimicrobial agents and chemotherapy Vol. 67; no. 10; p. e0043723
Main Authors Hess, Kyle A, Kooda, Kirstin, Shirley, Joshua D, Schuetz, Audrey N, Abu Saleh, Omar, Stevens, Ryan W
Format Journal Article
LanguageEnglish
Published United States American Society for Microbiology 01.10.2023
Subjects
Aged
Anti-Bacterial Agents - pharmacology
Anti-Bacterial Agents - therapeutic use
Bacterial Proteins - genetics
Challenging Clinical Case
Endocarditis
Endocarditis, Bacterial - drug therapy
Humans
Methicillin-Resistant Staphylococcus aureus - genetics
Microbial Sensitivity Tests
Oxacillin - pharmacology
Oxacillin - therapeutic use
Penicillin-Binding Proteins - genetics
Polymerase Chain Reaction
Staphylococcal Infections - drug therapy
Staphylococcus aureus - genetics
MODSA
BORSA
mecA
MRSA
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Summary:Genotypic testing for / is heavily relied upon for rapid optimization of antimicrobial therapy in infections due to Staphylococcus aureus. Little is known regarding optimal reporting and/or therapy for patients demonstrating lack of genotypic evidence of or but phenotypic oxacillin resistance. We report a case of a 77-year-old patient with S. aureus bloodstream infection and infective endocarditis with discordance between genotypic results and phenotypic susceptibility testing.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
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The authors declare no conflict of interest.
This Journal section presents a real, challenging case involving a multidrug-resistant organism. The case authors present the rationale for their therapeutic strategy and discuss the impact of mechanisms of resistance on clinical outcome. An expert clinician then provides a commentary on the case.
ISSN:0066-4804
1098-6596
1098-6596
DOI:10.1128/aac.00437-23