title: Fatal levofloxacin failure in treatment of a bacteremic patient infected with Streptococcus pneumoniae with a preexisting parC mutation.
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.
authors.affiliation: Departamento de Microbiología, Hospital Virgen Macarena, Avda. Dr. Fedriani s/n, 41009 Seville, Spain. m@marinadecueto.e.telefonica.net
authors.forename: M
authors.initials: M
authors.lastname: de Cueto
authors.forename: J M
authors.initials: JM
authors.lastname: Rodríguez
authors.forename: M J
authors.initials: MJ
authors.lastname: Soriano
authors.forename: L
authors.initials: L
authors.lastname: López-Cerero
authors.forename: J
authors.initials: J
authors.lastname: Venero
authors.forename: A
authors.initials: A
authors.lastname: Pascual
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology; D027081:DNA Gyrase / Q000235:genetics; D027101:DNA Topoisomerase IV / Q000235:genetics*; D024881:Drug Resistance, Bacterial / Q000235:genetics; D017809:Fatal Outcome; D006801:Humans; D064704:Levofloxacin; D008297:Male; D009154:Mutation; D015242:Ofloxacin / Q000627:therapeutic use*; D011018:Pneumonia, Pneumococcal / Q000188:drug therapy* / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D015242:Ofloxacin; D027101:DNA Topoisomerase IV; D027081:DNA Gyrase