Fatal levofloxacin failure in treatment of a bacteremic patient infected with Streptococcus pneumoniae with a preexisting parC mutation

J Clin Microbiol. 2008 Apr;46(4):1558-60. doi: 10.1128/JCM.02066-07. Epub 2008 Feb 20.

Abstract

The fatal outcome of levofloxacin treatment in a patient with bacteremic pneumonia caused by Streptococcus pneumoniae with a preexisting parC mutation is reported. Failure was due to the emergence of a gyrA mutation after 4 days of therapy. Problems encountered in detecting first-step mutation isolates are discussed.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteremia / drug therapy*
  • Bacteremia / microbiology
  • DNA Gyrase / genetics
  • DNA Topoisomerase IV / genetics*
  • Drug Resistance, Bacterial / genetics
  • Fatal Outcome
  • Humans
  • Levofloxacin*
  • Male
  • Mutation*
  • Ofloxacin / therapeutic use*
  • Pneumonia, Pneumococcal / drug therapy*
  • Pneumonia, Pneumococcal / microbiology
  • Streptococcus pneumoniae / drug effects*
  • Streptococcus pneumoniae / enzymology
  • Streptococcus pneumoniae / genetics
  • Treatment Failure

Substances

  • Anti-Bacterial Agents
  • Levofloxacin
  • Ofloxacin
  • DNA Topoisomerase IV
  • DNA Gyrase