Open AccessEmergence of Ceftriaxone Resistance during a Case of Pneumococcal Meningitis with Fatal Evolution
Author(s) -
Assaf Mizrahi,
Jean-Christophe Marvaud,
Benoît Pilmis,
J.C. Nguyen Van,
C. Couzigou,
Cédric Bruel,
Nicolas Engrand,
Alban Le Monnier,
Thierry Lambert
Publication year - 2020
Publication title -
antimicrobial agents and chemotherapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.07
H-Index - 259
eISSN - 1070-6283
pISSN - 0066-4804
DOI - 10.1128/aac.01958-19
Subject(s) - ceftriaxone , streptococcus pneumoniae , meningitis , cerebrospinal fluid , medicine , penicillin , cephalosporin , dexamethasone , vasculitis , microbiology and biotechnology , antibiotics , immunology , surgery , biology , disease
We report a case of a 62-year-old man treated for Streptococcus pneumoniae meningitis by ceftriaxone and dexamethasone. After neurological improvement, neurological degradation by vasculitis occurred, despite effective concentrations of ceftriaxone in the serum and cerebrospinal fluid (CSF). S. pneumoniae with increased MICs to third-generation-cephalosporins (3GC) was isolated from the ventricular fluid 10 days after the isolation of the first strain. Isolate analysis showed that a mutation in the penicillin-binding protein 2X (PBP2X) has occurred under treatment.