In Vivo-Acquired Resistance to Daptomycin during Methicillin-Resistant Bacteremia.

Daptomycin (DAP) represents an interesting alternative to treat methicillin-resistant (MRSA) infections. Different mechanisms of DAP resistance have been described; however, in vivo-acquired resistance is uncharacterized. This study described the phenotypic and genotypic evolution of MRSA strains that became resistant to DAP in two unrelated patients with bacteremia under DAP treatment, in two hospitals in the South of France.

[Hemolysis interference on clinical chemistry tests analyzed on DxC 700 AU (Beckman Coulter®) and kaliemia rendering algorithm].

The influence of hemolysis was evaluated for 26 clinical chemistry parameters on DxC 700AU (Beckman Coulter®). Ten sample pools were prepared and separated into six aliquots. These aliquots were overloaded with hemolysis in increasing amounts to reach levels equivalent to the maximum hemolysis thresholds H1 (+), H2 (++), H3 (+++) and H4 (++++).

Isolated from Diabetic Foot Osteomyelitis: Clonal Diversity, Resistance Profile, Virulence Potential, and Genome Adaptation.

This study assessed the clonal diversity, the resistance profile and the virulence potential of strains isolated from diabetic foot infection (DFI) and diabetic foot osteomyelitis (DFOM). A retrospective single-centre study was conducted on patients diagnosed with isolated from deep DFI and DFOM at Clinique du Pied Diabétique Gard-Occitanie (France) over a two-year period. Phylogenetic backgrounds, virulence factors (VFs) and antibiotic resistance profiles were determined.

Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies.

Multiple modes of interventions are available when implementing an antibiotic stewardship program (ASP), however, their complementarity has not yet been assessed. In a 938-bed hospital, we sequentially implemented four combined modes of interventions over one year, centralized by one infectious diseases specialist (IDS): (1) on-request infectious diseases specialist consulting service (IDSCS), (2) participation in intensive care unit meetings, (3) IDS intervention triggered by microbiological laboratory meetings, and (4) IDS intervention triggered by pharmacist alert. We assessed the complementarity of the different cumulative actions through quantitative and qualitative analysis of all interventions traced in the electronic medical record.