Emergence of Ceftriaxone Resistance during a Case of Pneumococcal Meningitis with Fatal Evolution.

Abstract

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.

• Authors: A Mizrahi, J C Marvaud, B Pilmis, J C Nguyen Van, C Couzigou, C Bruel, N Engrand, A Le Monnier, T Lambert
• Journal: Antimicrobial agents and chemotherapy (Antimicrob Agents Chemother) Vol. 64 Issue 3 (02 21 2020) ISSN: 1098-6596 [Electronic] United States
• PMID: 31712218 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2020 American Society for Microbiology.

Chemical References

• Cephalosporins
• Penicillin-Binding Proteins
• PBP 2x protein, Streptococcus
• Ceftriaxone
• Dexamethasone

Topics

• Ceftriaxone (blood, pharmacokinetics, therapeutic use)
• Cephalosporins (blood, pharmacokinetics, therapeutic use)
• Dexamethasone (blood, pharmacokinetics, therapeutic use)
• Humans
• Male
• Meningitis, Pneumococcal (blood, drug therapy, metabolism)
• Microbial Sensitivity Tests
• Middle Aged
• Penicillin-Binding Proteins (genetics, metabolism)
• Streptococcus pneumoniae (drug effects, pathogenicity)