Enterobacter meningitis--treatment complicated by emergence of mutants resistant to cefotaxime.
A case of Enterobacter cloacae meningitis in a postoperative patient is reported. A slow response to cefotaxime necessitated the use of gentamicin and trimethoprim-sulfamethoxazole for cure. Two types of resistance in the strain of E. cloacae isolated to cefotaxime were demonstrated: an inducible beta-lactamase that likely was the cause of the poor response to cefotaxime and a constitutive beta-lactamase in a mutant strain detected by a disc susceptibility test.
Ralph
E D
ED
Department of Medicine (Infectious Diseases), University Hospital, London, Ontario, Canada.
Behme
R J
RJ
D000368:Aged; D002439:Cefotaxime / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D004754:Enterobacter / Q000235:genetics*; D004755:Enterobacteriaceae / Q000235:genetics*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008581:Meningitis / Q000188:drug therapy* / Q000209:etiology; D009154:Mutation
D002439:Cefotaxime