A 37-year old African-Canadian male (weight 77 kg, height 180 cm), with a documented history of hypertension and type II diabetes, had been receiving hemodialysis for 4 months prior to this encounter. MSSA was recovered from blood samples withdrawn via CVC (which was inserted 2 months earlier) and peripheral veins. The treatment regimen consisted of cefazolin 2 g i.v. thrice weekly after dialysis plus cefazolin (5 mg/mL)/heparin (5,000 units/mL) antibiotic lock instilled at the end of each dialysis for 2 weeks; the treatment started as inpatient and continued in the outpatient dialysis unit. All repeat cultures were negative and the permanent catheter was not removed for the follow-up period of 3 months.
A 62-year-old white male (weight 125 kg, height 167 cm), with a known history of type II diabetes, heart disease, hypertension, stroke (paraplegic), and on hemodialysis 98 months prior to this infection incident, developed bacteremia secondary to coagulase-negative Staphylococcus from the CVC. The patient received vancomycin 2,000 mg i.v. (16 mg/kg) for 2 consecutive dialysis sessions followed by vancomycin 1,000 mg i.v. after each subsequent dialysis plus vancomycin 2.5 mg/mL/4% citrate lock for 2 weeks total with complete cure, and the patient continued using the same catheter in the 6-month follow-up period.