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Prosthetic Valve Endocarditis Caused by Staphylococcus epidermidis

1985; American Medical Association; Volume: 253; Issue: 19 Linguagem: Inglês

10.1001/jama.1985.03350430079030

1538-3598

Bruce Chamovitz, Richard E. Bryant, David N. Gilbert, Alan I. Hartstein,

Viral Infections and Immunology Research

Development of rifampin-resistant Staphylococcus epidermidis was documented in three patients receiving vancomycin and rifampin therapy for prosthetic valve endocarditis. The minimum inhibitory concentrations and minimum bactericidal concentrations of rifampin for the original three isolates were 0.4 micrograms/mL or less. Organisms cultured during relapse or prosthetic valve replacement had minimum inhibitory concentrations of rifampin that were 12.5, 50, and greater than 100 micrograms/mL, respectively. Surgical intervention was necessary in all patients. One died, and one required a second prosthetic valve placement. The patients were treated with vancomycin plus aminoglycoside following identification of rifampin resistance. These observations suggest that vancomycin and rifampin may not be adequate therapy for prosthetic valve endocarditis caused by S epidermidis.