25155594 Visualization

A 20 Age - year Age - old Age male Sex with cystic History fibrosis History was transferred Clinical_event to Houston Nonbiological_location Methodist Nonbiological_location Hospital Nonbiological_location in January Date 2013 Date to be evaluated Clinical_event for lung Biological_structure and kidney Biological_structure transplant Therapeutic_procedure .
Patients with cystic fibrosis are known to develop chronic lung infections that adapt over time to this unique anatomic niche (14, 15).
His complicated medical history included pancreatic Disease_disorder insufficiency Disease_disorder , liver Biological_structure transplantation History in History 2004 Date , steroid History - induced History diabetes Disease_disorder , end Disease_disorder - stage Disease_disorder renal Disease_disorder disease Disease_disorder , and testicular Disease_disorder cancer Disease_disorder .
He had a long history of respiratory Disease_disorder infections Disease_disorder with History several History multidrug Disease_disorder - resistant Disease_disorder bacteria Disease_disorder , including History MRSA Disease_disorder .
He was treated with ceftaroline Medication at an outside Nonbiological_location hospital Nonbiological_location immediately prior to transfer Clinical_event to Houston Nonbiological_location Methodist Nonbiological_location Hospital Nonbiological_location .
The patient was periodically Frequency hospitalized Clinical_event from January Duration to Duration July Duration 2013 Duration and was treated for recurrent respiratory Biological_structure and catheter Detailed_description - related Detailed_description infections Disease_disorder caused by MRSA Disease_disorder and multidrug Disease_disorder - resistant Disease_disorder Pseudomonas Disease_disorder aeruginosa Disease_disorder .
His antibiotic Medication exposure included long treatment courses with various agents, including meropenem Medication , ceftazidime Medication , doxycycline Medication , vancomycin Medication , linezolid Medication , cefepime Medication , ciprofloxacin Medication , and inhaled Administration and systemic Administration colistin Medication and tobramycin Medication .
Shortly after being readmitted Clinical_event to our hospital Nonbiological_location in June Date 2013 Date , MRSA Disease_disorder was grown from cultures Diagnostic_procedure of blood Biological_structure and respiratory Biological_structure specimens Biological_structure .
These two isolates Coreference were resistant Lab_value to clindamycin Diagnostic_procedure , linezolid Diagnostic_procedure , oxacillin Diagnostic_procedure , and trimethoprim Diagnostic_procedure - sulfamethoxazole Diagnostic_procedure and susceptible Lab_value to minocycline Diagnostic_procedure , rifampin Diagnostic_procedure , and vancomycin Diagnostic_procedure .
His blood Biological_structure isolate Diagnostic_procedure grew Lab_value confluently Lab_value around the ceftaroline Diagnostic_procedure Etest Diagnostic_procedure strip Diagnostic_procedure , yielding an MIC Lab_value of Lab_value >32 Lab_value mg/liter Lab_value .
Five Lab_value additional S. Disease_disorder aureus Disease_disorder respiratory Biological_structure tract Biological_structure isolates Diagnostic_procedure were available for further study.
All MRSA isolates from this patient had a small-colony-variant (SCV) phenotype.