A 34-year-old white female (weight 46 kg, height 166 cm) with a medical history significant for type I diabetes, hypertension, ischemic heart disease, and on hemodialysis for 3 years prior to this encounter, grew coagulase-negative Staphylococcus from her CVC (oxacillin susceptible), where the catheter was changed on the same day of suspected blood stream infection. The patient was treated with parenteral cefazolin 2 g thrice weekly after each dialysis session in addition to cefazolin (5 mg/mL)/heparin (5,000 units/mL) lock solution for the duration of 1 week as deemed appropriate by the prescribing physician. The treatment was initiated and completed in the inpatient setting. Repeated cultures were all negative and the catheter remained in place with no recurrence in the 3-month follow-up period.
An 81-year-old quadriplegic African-Canadian female (weight 64 kg, height 152.5 cm), with a known history of hypertension, type II diabetes, and requiring hemodialysis 55 months prior to this encounter, was diagnosed with MSSA bacteremia, with blood samples collected from the CVC (which was inserted 21 months before the incidence of bacteremia) and peripheral veins. A prescription for cefazolin 2 g i.v. after each dialysis and cefazolin (5 mg/mL)/heparin (5,000 units/mL) lock solution for 2 weeks were administered. Treatment was started in the outpatient dialysis unit. All repeat cultures were negative and the catheter was conserved intact. The patient expired 60 days later after admission; she was found unresponsive at a nursing home.