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Correspondence
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Volume 341:207-208 July 15, 1999 Number 3
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Vancomycin Resistance in Staphylococcus aureus

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To the Editor: The first patient described by Smith et al. (Feb. 18 issue)1 had five bouts of peritonitis with methicillin-resistant Staphylococcus aureus. All were treated with intravenous vancomycin. The patient's peritoneal catheter remained in place. The catheter was not removed even when intermediate glycopeptide resistance developed in the patient's S. aureus isolate and therapy with combined intravenous and intraperitoneal vancomycin failed. The accompanying editorial2 points out that in an animal model, the presence of prosthetic material led to increased resistance in S. aureus to all antibiotics tested.3 In the patient described by Smith et al., the peritoneal catheter probably . . . [Full Text of this Article]

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