Listeria grayi: vancomycin-resistant, gram-positive rod causing bacteremia in a stem cell transplant recipient

Transpl Infect Dis. 2010 Dec;12(6):526-8. doi: 10.1111/j.1399-3062.2010.00539.x.

Abstract

We report the first case of Listeria grayi bacteremia in a stem cell transplant recipient. The patient developed bacteremia with a gram-positive rod that was initially thought to be Corynebacterium species and a skin contaminant. The organism grew in multiple blood cultures and therapy with vancomycin was initiated. The API Coryne (version 3.0) identified the organism as L. grayi. Susceptibility testing by Etest suggested that the organism was resistant to vancomycin, but susceptible to ampicillin. After therapeutic change from vancomycin to ampicillin, the bacteremia cleared. Empiric therapy with vancomycin for all gram-positive bacterial infections is not appropriate. Accurate identification and antibiotic susceptibility is important, particularly in those with persistent bacteremia.

MeSH terms

  • Adult
  • Ampicillin / therapeutic use
  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / microbiology*
  • Drug Resistance, Bacterial*
  • Female
  • Humans
  • Listeria / classification
  • Listeria / drug effects*
  • Listeria / isolation & purification
  • Listeriosis / microbiology
  • Microbial Sensitivity Tests
  • Stem Cell Transplantation / adverse effects*
  • Treatment Outcome
  • Vancomycin / pharmacology*
  • Vancomycin / therapeutic use
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Vancomycin
  • Ampicillin