Emergence of Levofloxacin-Resistant Pneumococci in Immunocompromised Adults after Therapy for Community-Acquired Pneumonia
| Autor: | Kevin B. Anderson, Donald E. Low, Thomas M. File, Barbara M. Willey, Joseph R. DiPersio, James S. Tan |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Microbiology (medical) Ofloxacin Levofloxacin Microbial Sensitivity Tests Drug resistance medicine.disease_cause Pneumococcal Infections Immunocompromised Host Anti-Infective Agents Community-acquired pneumonia Streptococcus pneumoniae medicine Humans Antibacterial agent business.industry Drug Resistance Microbial Pneumonia Pneumococcal medicine.disease Community-Acquired Infections Pneumonia Pneumococcal infections Infectious Diseases Immunology Sputum medicine.symptom business medicine.drug |
| Zdroj: | Clinical Infectious Diseases. 37:376-381 |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1086/376642 |
| Popis: | We describe 4 patients infected with levofloxacin-resistant pneumococci after therapy for community-acquired pneumonia (CAP). The 4 patients had 15 episodes of CAP; Streptococcus pneumoniae was isolated from blood or sputum samples obtained during 14 of the episodes. The underlying medical condition was Bruton agammaglobulinemia in 3 patients and chronic lymphoid leukemia in the other. The initial episode of CAP in each patient was due to a levofloxacin-susceptible strain. One of 4 reinfections and 5 of 6 relapses were due to levofloxacin-resistant strains. All of these strains had amino acid substitutions in the quinolone-resistance-determining region of the genes parC and gyrA. The time between episodes of pneumonia varied from 1 to 4 months. In immunocompromised patients with suspected or proven pneumococcal infection, it may be prudent not to use fluoroquinolone monotherapy empirically when the patient has a history of fluoroquinolone therapy in at least the past 4 months. |
| Databáze: | OpenAIRE |
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