ABSTRACT
Daptomycin is a novel bactericidal agent active against Gram-positive pathogens including meticillin-resistant Staphylococcus aureus (MRSA). Our case is unique in the description of an MRSA USA 300 isolate that developed decreased susceptibility to daptomycin during daptomycin and vancomycin therapy. Directed sequencing detected a previously reported mutation in mprF, resulting in a T345A substitution, associated with non-susceptibility to daptomycin.
Subject(s)
Daptomycin/therapeutic use , Staphylococcal Infections/drug therapy , Staphylococcus aureus/drug effects , Adult , Anti-Bacterial Agents , Hepatitis C/complications , Humans , Male , Methicillin Resistance , Staphylococcus aureus/isolation & purification , Substance Abuse, Intravenous/complicationsSubject(s)
Immunosuppressive Agents/adverse effects , Kidney Transplantation , Lung Diseases, Interstitial/chemically induced , Postoperative Complications/chemically induced , Sirolimus/adverse effects , Aged , Diagnosis, Differential , Drug Therapy, Combination , Follow-Up Studies , Humans , Immunosuppressive Agents/therapeutic use , Lung Diseases, Interstitial/diagnosis , Lung Volume Measurements , Male , Postoperative Complications/diagnosis , Sirolimus/therapeutic use , Tomography, X-Ray ComputedABSTRACT
Gender inequity in access to hemodialysis and kidney transplantation has created a public health crisis in the US. Women have a lower chance of receiving hemodialysis and kidney transplant than men, but they constitute the majority of living kidney donors. Research has shown that economic factors such as greater income of men may encourage females to be donors; while gender-bias on part of physicians or institutions, lack of social support networks and differences in health-seeking behaviors compared to men are cited as reasons for this imbalance. We suggest various strategies to improve participation of women in the transplant process by education; raising awareness by publishing gender-specific data for dialysis and transplant centers; education and workshops to eliminate gender-bias within institutions and health-care providers and establishment of gender-specific support groups. Transplant teams that are more sensitive to the social complexities of women's lives may lead to increased understanding of the effects of renal disease and indicate measures that need to be in place in order to address this gender disparity in the treatment of renal failure. Research needs to be done to elucidate the underlying medical, societal or psychological processes that lead to gender bias in the field of kidney transplantation.
