Table 1 Selected baseline clinical characteristics of patients infected with VRE UTIs selected for daptomycin therapy
Patient | Age (y)/Sex | Weight (kg) | Medical history | Previous UTIs | Foley catheter | Cr (mg/dL)/ CrCl (mL/min) | Urinalysis (WBC/hpf) | VRE isolate | VRE culture (CFU/mL) | Susceptibilities |
|---|---|---|---|---|---|---|---|---|---|---|
Normal kidney function | ||||||||||
1 | 72/F | 67 | Long hospital stay after surgery for large mucinous adenocarcinoma of the ovary; ADM: lethargy thought secondary to sedative overdose | No | No | 0.6/90 | 40-50 | E. faecium | 50,000 | R: AMP, LNZ, TET, VAN; S: GEN, QD, TIG |
2 | 61/F | 107 | MS, neurogenic bladder; ADM: MS flare, Pseudomonas spp. UTI treated with CIP | Yes | Yes | 0.8/100 | 60-65 | E. faecium | 30,000 | R: PCN, TET, VAN; I: NFT; S: DAP |
3 | 30/M | 66 | C5 quadriplegia, neurogenic bladder, recent UTIs caused by Pseudomonas aeruginosa; ADM: abdominal pain, cloudy urine, treated empirically with TOB | Yes | No | 0.2/>120 | >100 | E. faecalis | 100,000 | R: TET, VAN; S: DAP, PCN |
Mild kidney disease (CKD 2) | ||||||||||
4 | 70/F | 66 | Neurogenic bladder, nephrolithiasis; ADM: lethargy, hypotension | Yes | Yes | 0.6/83 | 25-30 | E. faecium | >100,000 | R: AMP, PCN, VAN |
5 | 67/F | 109 | ADM: acute on chronic respiratory failure due to CHF, hypoventilation secondary to obesity; initially required intubation and ventilation in the ICU, developed fever (101°F); initially unspecified Enterococcus infection treated with VAN and CEF | No | No | 1.4/63 | NP | E. faecium | 5000 | R: AMP, NFT, VAN |
Moderate kidney disease (CKD 3) | ||||||||||
6 | 83/F | 55 | Acute exacerbation of COPD | No | No | 1.1/34 | TNTC | E. faecium | >100,000 | R: PCN, TET, VAN; I: NFT |
7 | 83/F | 77 | Stays at a nursing home; recently hospitalized for stenting of right femoral artery for vascular disease | No | No | 1.2/46 | 25-50 | E. faecium | 40,000 | R: NFT, PCN, TET, VAN; S: DAP |
8 | 86/M | 70 | CKD stage 3, nephrolithiasis, obstructive uropathy with benign prostatic hypertrophy, recent UTI caused by E. coli and P. aeruginosa; ADM: bloody urine, initial evaluation revealed infection with E. coli and P. aeruginosa, treated with CEF | Yes | Yes | 1.1/43 | 10-15 | E. faecium | 80,000 | R: PCN, TET, VAN |
Severe kidney disease/kidney failure (CKD 4–5) | ||||||||||
9 | 90/F | 60 | Severe dementia, stays at extended-care facility; ADM: decreased oral intake, abdominal pain, fever (100.9°F) | Yes | No | 1.1/26 | TNTC | E. faecium | >100,000 | R: AMP, CIP, NFT, TET, VAN |
10 | 60/M | 81 | Liver transplant for hepatitis C cirrhosis; ADM: chest pain, E. coli empyema complicating previous CABG surgery | No | No | 4.1/19 | NP | E. faecium | 100,000 | R: DOX, PCN, VAN |