Reminder of important clinical lesson
Management of recurrent pacemaker-related bacteraemia with small colony variant Staphylococcus aureus in a haemodialysis patient
1 Næstved Sygehus, Clinical Microbiology, Herlufvænge 14A, Næstved, 4700, Denmark
2 Rigshospitalet, Copenhagen University Hospital, Department of Nephrology, Blegdamsvej 9, Copenhagen, 2100, Denmark
3 Rigshospitalet, Copenhagen University Hospital, Department of Clinical Microbiology, Blegdamsvej 9, Copenhagen, 2100, Denmark
4 Hvidovre Hospitalet, Department of Clinical Microbiology, Kettegård alle 30, Copenhagen, 2650, Denmark
5 Statens Serum Institut, Department of Bacteriology, Mycology and Parasitology, Artillerivej 5, Copenhagen, 2300, Denmark
Correspondence to:
Xiaohui Chen Nielsen, xcn{at}regionsjaelland.dk
A patient with chronic haemodialysis with a cardiac pacemaker was admitted for five episodes of bacteraemia with Staphylococcus during an 8-month period. The species identification was complicated since the morphological characters and biochemical reactions were unusual and differing. Molecular biological identification and typing methods revealed that the pathogens for all the episodes were the same strain of Staphylococcus aureus that had small colony variant characteristics. Continuous suppressive antibiotic treatment initiated after the last infection episode has been able to keep the patient free of bacteraemia relapse during the past 24 months without removing the pacemaker.
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