title: Community-acquired pneumonia caused by carbapenem-resistant Streptococcus pneumoniae: re-examining its prevention and treatment.
abstract: A 73-year-old man with no significant past medical history or any history of health care visits was hospitalized for pneumonia. Sputum culture revealed multidrug-resistant Streptococcus pneumoniae, even to carbapenems. The patient was later treated successfully with levofloxacin. Throat cultures from his two grandchildren revealed S. pneumoniae with the same susceptibility pattern. Analysis for resistant genes revealed gPRSP (pbp1a + pbp2x + pbp2b gene variants) in both the patient and his grandchildren, none of whom had received pneumococcal vaccines of any kind. This case illustrates the importance of the emergence of carbapenem-resistant S. pneumoniae. Non-rational use of carbapenems for community-acquired infections may be counterproductive. This case also highlights the importance of pneumococcal vaccinations in children and the elderly.
authors.affiliation: Department of Infectious Diseases, Kobe City Medical Center General Hospital, Japan ; Department of General Internal Medicine, Kobe City Medical Center General Hospital, Japan.
authors.forename: Asako
authors.initials: A
authors.lastname: Doi
authors.affiliation: Division of Infectious Diseases, Kobe University Hospital, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Iwata
authors.affiliation: Department of Laboratory Medicine, Kobe City Medical Center General Hospital, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takegawa
authors.affiliation: Hyogo Health Service Association, Hyogo, Japan.
authors.forename: Kanji
authors.initials: K
authors.lastname: Miki
authors.affiliation: Department of Infectious Diseases, Kobe City Medical Center General Hospital, Japan ; Department of General Internal Medicine, Kobe City Medical Center General Hospital, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Sono
authors.affiliation: Department of General Internal Medicine, Kobe City Medical Center General Hospital, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nishioka
authors.affiliation: Foundation of Biochemical Research and Innovation, Osaka, Japan.
authors.forename: Jumpei
authors.initials: J
authors.lastname: Takeshita
authors.affiliation: Department of Pulmonary Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Tomii
authors.affiliation: Department of Infectious Diseases, Kobe City Medical Center General Hospital, Japan.
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Haruta
keywords: Streptococcus pneumoniae; carbapenem resistance; pneumonia