micafungin and Bacteremia

Kodamaea ohmeri is a rare yeast pathogen that has recently emerged as an important cause of fungemia in immunocompromised patients. However, appropriate therapy for this infection remains unclear. We report a case of catheter-related blood stream infection caused by K. ohmeri in a 58-year-old patient who improved after removal of the central venous catheter and administration of micafungin. Considering the antibiotic susceptibility of this pathogen and reviewing literature, echinocandins may be the first choice for an empiric therapy for this pathogen.

Topics: Antifungal Agents; Bacteremia; Catheter-Related Infections; Echinocandins; Female; Humans; Lipopeptides; Micafungin; Microbial Sensitivity Tests; Middle Aged; Mycoses; Saccharomycetales

Studies have demonstrated that ECMO leads to pharmacokinetic changes, with alterations in volume of distribution, clearance and drug sequestration by the circuit. We describe a successful dosing approach for daptomycin and micafungin for the treatment of VRE faecium bacteremia and C. glabrata fungemia in a patient receiving veno-venous ECMO and CRRT.. We report a case of a patient with ARDS on veno-venous ECMO complicated by VRE faecium bacteremia and C. glabrata fungemia. The patient was treated with daptomycin 10 mg/kg every 24 h and micafungin 150 mg every 24 h for 14 days. Key observations included the documented bacteremia and fungemia clearance without the need for ECMO circuit exchange.. This case report demonstrates successful bacteremia and fungemia clearance in an adult without the need for ECMO circuit exchange. It also highlights the need for more research to identify optimal antimicrobial dosing strategies in similar scenarios.

Topics: Aged; Anti-Infective Agents; Bacteremia; Candida glabrata; Candidemia; Continuous Renal Replacement Therapy; Daptomycin; Dose-Response Relationship, Drug; Enterococcus faecium; Extracorporeal Membrane Oxygenation; Humans; Male; Micafungin; Vancomycin-Resistant Enterococci