J Chemother. 2014 Jun;26(3):173-5. doi: 10.1179/1973947813Y.0000000125. Epub 2013 Dec 6.
An unexpected Streptococcus pneumoniae strain.
Cenderello G, Pontali E, Torresin A, Milano G, Ansaldi F, Feasi M, Usiglio D, Mori M, Icardi G, Cassola G.
Abstract
This clinical driven report describes the unexpected detection of a multidrug resistant (MDR) Streptococcus pneumoniae strain. Italy is usually considered a country characterized by a low prevalence of MDR S. pneumoniae. We describe the occurrence of bacterial meningitis sustained by a MDR S. pneumoniae strain in Italy. The first-line treatment was started with ceftriaxone and dexamethasone, but after the identification of such a resistant strain a second-line regimen was needed. The new regimen was chosen on both susceptibility and pharmacokinetic criteria. Linezolid and levofloxacin were started and a dramatic improvement was observed. A more sensitive anamnesis revealed some elements known to be associated to a MDR S. pneumoniae occurrence (immunesuppression, former antibiotic therapy). So this case should pinpoint our attention on risk factors of MDR for a careful choice of antibiotic therapy in serious pneumococcal infections.
KEYWORDS:
Immunecompromised host,; Linezolid treatment; S.pneumoniae MDR strain,; S.pneumoniae meningitis,
PMID: 24090710 [PubMed - in process]
An unexpected Streptococcus pneumoniae strain.
Cenderello G, Pontali E, Torresin A, Milano G, Ansaldi F, Feasi M, Usiglio D, Mori M, Icardi G, Cassola G.
Abstract
This clinical driven report describes the unexpected detection of a multidrug resistant (MDR) Streptococcus pneumoniae strain. Italy is usually considered a country characterized by a low prevalence of MDR S. pneumoniae. We describe the occurrence of bacterial meningitis sustained by a MDR S. pneumoniae strain in Italy. The first-line treatment was started with ceftriaxone and dexamethasone, but after the identification of such a resistant strain a second-line regimen was needed. The new regimen was chosen on both susceptibility and pharmacokinetic criteria. Linezolid and levofloxacin were started and a dramatic improvement was observed. A more sensitive anamnesis revealed some elements known to be associated to a MDR S. pneumoniae occurrence (immunesuppression, former antibiotic therapy). So this case should pinpoint our attention on risk factors of MDR for a careful choice of antibiotic therapy in serious pneumococcal infections.
KEYWORDS:
Immunecompromised host,; Linezolid treatment; S.pneumoniae MDR strain,; S.pneumoniae meningitis,
PMID: 24090710 [PubMed - in process]
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