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Infectious Diseases Volume 48, 2016 - Issue 9
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Brief Report

Failure of combination therapy for Staphylococcus aureus bone infection: a case of in vivo selection with resistance to rifampicin and fusidic acid

Guillaume G. AubinService de Bactériologie-Hygiène hospitalière, CHU de Nantes, Institut de Biologie, Nantes Cedex, France; ;Faculté de Médecine, EA3826 Thérapeutiques Cliniques et Expérimentales des Infections, Université de Nantes, Nantes, France; ;Nantes study group members of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest), Nantes, France;
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Pascale BémerService de Bactériologie-Hygiène hospitalière, CHU de Nantes, Institut de Biologie, Nantes Cedex, France; ;Nantes study group members of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest), Nantes, France;
,
Aurélie GuillouzouicService de Bactériologie-Hygiène hospitalière, CHU de Nantes, Institut de Biologie, Nantes Cedex, France;
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Elise LaunayService de Pédiatrie, CHU de Nantes, Nantes, France;
,
Loïc GeffroyService de Chirurgie Pédiatrique, CHU de Nantes, Nantes, France;
,
Sophie TouchaisNantes study group members of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest), Nantes, France; ;Service de Chirurgie Orthopédique Traumatologie, CHU de Nantes, Nantes, France
&
Stéphane CorvecService de Bactériologie-Hygiène hospitalière, CHU de Nantes, Institut de Biologie, Nantes Cedex, France; ;Faculté de Médecine, EA3826 Thérapeutiques Cliniques et Expérimentales des Infections, Université de Nantes, Nantes, France; ;Nantes study group members of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest), Nantes, France; Correspondence[email protected]
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Pages 699-702 | Received 19 Jan 2016, Accepted 19 Apr 2016, Published online: 19 May 2016
 
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Abstract

Staphylococcus aureus is one of the main etiologies of bone and device-related infections. Treatment of these orthopedic infections combines mostly rifampicin with other antibiotics. The recurrence or failure rate after fusidic acid/rifampicin treatment remains low (<10%). We discuss here a case of antibiotic treatment failure for Staphylococcus aureus bone infection with in vivo selection of rifampicin and fusidic acid resistance. We also report a new mutation in fusA gene involved in fusidic acid resistance.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this report.

Funding information

This project was funded by an internal grant at Nantes University Hospital.

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