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Journal of Clinical Microbiology, April 2008, p. 1558-1560, Vol. 46, No. 4
0095-1137/08/$08.00+0     doi:10.1128/JCM.02066-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

CASE REPORT

Fatal Levofloxacin Failure in Treatment of a Bacteremic Patient Infected with Streptococcus pneumoniae with a Preexisting parC Mutation{triangledown}

M. de Cueto,1,2* J. M. Rodríguez,2 M. J. Soriano,3 L. López-Cerero,1,2 J. Venero,3 and A. Pascual1,2

Department of Microbiology, University Hospital Virgen Macarena, Seville, Spain,1 Department of Microbiology, School of Medicine, University of Seville, Seville, Spain,2 Department of Internal Medicine, University Hospital Virgen Macarena, Seville, Spain3

Received 24 October 2007/ Returned for modification 13 December 2007/ Accepted 9 February 2008

The fatal outcome of levofloxacin treatment in a patient with bacteremic pneumonia caused by Streptococcus pneumoniae with a preexisting parC mutation is reported. Failure was due to the emergence of a gyrA mutation after 4 days of therapy. Problems encountered in detecting first-step mutation isolates are discussed.


* Corresponding author. Mailing address: Departamento de Microbiología, Hospital Virgen Macarena, Avda. Dr. Fedriani s/n, 41009 Seville, Spain. Phone: 34-955008138. Fax: 34-954377413. E-mail: m{at}marinadecueto.e.telefonica.net

{triangledown} Published ahead of print on 20 February 2008.


Journal of Clinical Microbiology, April 2008, p. 1558-1560, Vol. 46, No. 4
0095-1137/08/$08.00+0     doi:10.1128/JCM.02066-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.