A Nosocomial Outbreak of Fluoroquinolone-Resistant Streptococcus pneumoniae

Over the course of a 20-month period, in a hospital respiratory ward in which ciprofloxacin was often used as empirical antimicrobial therapy for lower respiratory tract infections (LRTIs), 16 patients with chronic bronchitis developed nosocomial LRTIs caused by penicillin- and ciprofloxacin-resista...

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Bibliographic Details
Published in:Clinical infectious diseases Vol. 33; no. 4; pp. 517 - 522
Main Authors: Weiss, Karl, Restieri, C., Gauthier, Richard, Laverdière, Michel, McGeer, Allison, Davidson, Ross J., Kilburn, Laurie, Bast, Darrin J., de Azavedo, Joyce, Low, Donald E.
Format: Journal Article
Language:English
Published: Chicago, IL The University of Chicago Press 15-08-2001
University of Chicago Press
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Summary:Over the course of a 20-month period, in a hospital respiratory ward in which ciprofloxacin was often used as empirical antimicrobial therapy for lower respiratory tract infections (LRTIs), 16 patients with chronic bronchitis developed nosocomial LRTIs caused by penicillin- and ciprofloxacin-resistant Streptococcus pneumoniae (serotype 23 F). The minimum inhibitory concentration (MIC) of ciprofloxacin for all isolates from the first 9 patients was 4 µg/mL, in association with a parC mutation. Isolates from the subsequent 7 patients all had a ciprofloxacin MIC of 16 µg/mL, in association with an additional mutation in gyrA. The MICs for this isolate were 8 µg/mL of levofloxacin (resistant), 2 µg/mL of moxifloxacin and gatifloxacin (intermediately resistant), and 0.12 µg/mL of gemifloxacin. This outbreak demonstrates the ability of S. pneumoniae to acquire multiple mutations that result in increasing levels of resistance to the fluoroquinolones and to be transmitted from person to person.
Bibliography:ark:/67375/HXZ-K9PBJKSP-V
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ISSN:1058-4838
1537-6591
DOI:10.1086/322658