[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]
Emergence of ceftriaxone resistance during a pneumococcal meningitis with fatal evolution
A. Mizrahi, J.C. Marvaud, B. Pilmis, J.C. Nguyen Van, C. Couzigou, C. Bruel, N. Engrand, A. Le Monnier, T. Lambert
We report a case of a 62-year old man treated for a Streptococcus pneumoniae meningitis by ceftriaxone and dexamethasone. After a neurological improvement, neurological degradation by vasculitis occurred, despite effective concentrations of ceftriaxone in serum and CSF. S. pneumoniae with increased MICs to third-generation-cephalosporins (3GC) was isolated from the ventricular fluid ten days after the isolation of the first strain. Isolates analysis showed that a mutation of penicillin-binding proteins in PBP2x has occurred under treatment.
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Keywords: Antibiotics; Drugs Resistance; Ceftriaxone; Streptococcus pneumoniae; Meningitis.