An unexpected Streptococcus pneumoniae strain

作者：Cenderello Giovanni^*; Pontali Emanuele; Torresin Augusta; Milano Giulia; Ansaldi Filippo; Feasi Marcello; Usiglio David; Mori Marco; Icardi Giancarlo; Cassola Giovanni

来源：Journal of Chemotherapy, 2014, 26(3): 173-175.

DOI：10.1179/1973947813Y.0000000125

• S.pneumoniae meningitis
• S.pneumoniae MDR strain
• Immunecompromised host
• Linezolid treatment

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.

• 出版日期2014-6