Journal Article

A Nosocomial Outbreak of Fluoroquinolone-Resistant <i>Streptococcus pneumoniae</i>

Karl Weiss, C. Restieri, Richard Gauthier, Michel Laverdière, Allison McGeer, Ross J. Davidson, Laurie Kilburn, Darrin J. Bast, Joyce de Azavedo and Donald E. Low

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 4, pages 517-522
Published in print August 2001 | ISSN: 1058-4838
Published online August 2001 | e-ISSN: 1537-6591 | DOI:
A Nosocomial Outbreak of Fluoroquinolone-Resistant Streptococcus pneumoniae

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Over the course of a 20-month period, in a hospital respiratory ward in which ciprofloxacin was often used as empirical antimicrobial therapy for lower respiratory tract infections (LRTIs), 16 patients with chronic bronchitis developed nosocomial LRTIs caused by penicillin- and ciprofloxacin-resistant Streptococcus pneumoniae (serotype 23 F). The minimum inhibitory concentration (MIC) of ciprofloxacin for all isolates from the first 9 patients was 4 µg/mL, in association with a parC mutation. Isolates from the subsequent 7 patients all had a ciprofloxacin MIC of 16 µg/mL, in association with an additional mutation in gyrA. The MICs for this isolate were 8 µg/mL of levofloxacin (resistant), 2 µg/mL of moxifloxacin and gatifloxacin (intermediately resistant), and 0.12 µg/mL of gemifloxacin. This outbreak demonstrates the ability of S. pneumoniae to acquire multiple mutations that result in increasing levels of resistance to the fluoroquinolones and to be transmitted from person to person.

Journal Article.  3544 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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