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Diagn Microbiol Infect Dis. 2009 Oct;65(2):180-3. doi: 10.1016/j.diagmicrobio.2009.05.017.

Clinical failure of vancomycin in a dialysis patient with methicillin-susceptible vancomycin-heteroresistant S. aureus.

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Division of Infectious Diseases, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York 10065, USA.


We report a case of recurrent Staphylococcus aureus bacteremia in a patient who failed vancomycin due to a vancomycin-heteroresistant strain lacking methicillin resistance. Although initial isolates were susceptible, isolates obtained after vancomycin chemotherapy were vancomycin heteroresistant. This case thus illustrates the clinical emergence of vancomycin heteroresistance.

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