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Emergence of a Streptococcus pneumoniae Clinical Isolate Highly Resistant to Telithromycin and Fluoroquinolones

Servicio Antimicrobianos, Dpto. Bacteriología, Instituto Nacional de Enfermedades Infecciosas-ANLIS "Dr. Carlos G. Malbrán," Buenos Aires, Argentina,¹ Servicio de Microbiología, Intituto de Cardiología y Cirugía Cardiovascular Fundación Favaloro, Buenos Aires, Argentina,² Division of Infectious Diseases, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia³

Received 8 July 2005/ Returned for modification 12 August 2005/ Accepted 31 August 2005

Streptococcus pneumoniae is a major pathogen causing community-acquired pneumonia and acute bronchitis. Macrolides, fluoroquinolones (FQs), and, recently, telithromycin (TEL) constitute primary therapeutic options, and rare cases of resistance have been reported. In this report, we describe the emergence of an S. pneumoniae clinical isolate with high-level TEL resistance (MIC, 256 µg/ml) and simultaneous resistance to FQs. Ongoing studies are oriented to elucidate the precise mechanism of resistance to TEL.

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