Transthoracic echocardiography revealed no apparent vegetation. As we continued administering Vancomycin, swollen and reddened skin turned normal, but MRSA was positive on blood culture. We changed antibiotics, Vancomycin to Daptomycin. By changing antibiotics, blood culture turned negative. After administered antibiotics for 4 weeks, she was discharged and moved to another hospital to receive rehabilitation. Conclusions: Sometimes MRSA forms a biofilm. Vancomycin

doesn’t permeate a biofilm through inside easily. Daptomycin, however, penetrate through inside MK-2206 nmr and show antibacterial activity. In our case, successful treatment was done with Daptomycin. Daptomycin is one of the choice to treat graft infection by MRSA when it is intractable. 274 A CASE REPORT OF 2 SUCCESSFUL PREGNANCY OUTCOMES IN A FEMALE WITH END STAGE RENAL FAILURE SECONDARY TO FOCAL SEGMENTAL GLOMERULOSCLEROSIS S AGGARWAL1, S ROXBURGH1, A MATHER1, S MCGINN1, S SEEHO2, T NIPPITA2, M BROWN3 1Renal Medicine, Royal North Shore Hospital, St Leonards, NSW; 2Obstetrics and Gynaecology, Royal North Shore Hospital, St Leonards, NSW; 3Renal Medicine, St George Hospital, Kograh, NSW,

Australia Background: Successful pregnancy outcomes have been increasingly reported in patients with end stage kidney disease (ESKD) with improved haemodialysis regimes. We report 2 successful pregnancies in a 32 year old female with ESKD on chronic haemodialysis. Case Report: Our SB-3CT patient developed ESKD secondary to focal segmental glomerulosclerosis (FSGS) that was treated unsuccessfully with cyclophosphamide and steroids and progressed to dialysis by age Selleck Tanespimycin 20. She subsequently had a renal transplant aged 25 with disease recurrence resulting

in a return to nocturnal haemodialysis within 12 months. In 2009 she conceived and was managed with extended dialysis hours (36 hours/week with an average urea of 6 mmol/L) and correction of anaemia with increased dose of erythropoietin stimulating agents. At 33 + 6/40 gestation she developed preterm premature rupture of membranes (PPROM). She delivered a 2.3 kg male who developed severe nephrotic syndrome which resolved spontaneously by day 30. Genetic testing of both the mother and child did not reveal a familial or genetic form of FSGS. In 2012 she successfully progressed with a pregnancy after 2 miscarriages at 8/40 gestation. She remained on haemodialysis for 36 hours/week with an average urea of 4–6 mmol/L and a haemaglobin greater than 95 g/L. At 28 + 4/40 gestation she developed PPROM and went into spontaneous labour at 34 + 3/40 gestation. She delivered a 1.7 kg male with no evidence of nephrotic syndrome. Conclusions: This case supports the literature showing that extended hours of haemodialysis and correction of anaemia can preserve fertility and allow successful pregnancy outcomes in women on haemodialysis.