Azithromycin treatment failure in community-acquired pneumonia caused by Streptococcus pneumoniae resistant to macrolides by a 23S rRNA mutation

In this report, we describe an azithromycin treatment failure in community-acquired pneumonia. During the first three days of azithromycin, the patient’s symptoms worsened, and she was subsequently admitted to the hospital. Blood cultures were positive for a penicillin-susceptible, macrolide-resista...

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Bibliographic Details
Published in:Diagnostic microbiology and infectious disease 2002-06, Vol.43 (2), p.163-165
Main Authors: Kays, Michael B, Wack, Matthew F, Smith, David W, Denys, Gerald A
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - pharmacology
Anti-Bacterial Agents - therapeutic use
Azithromycin - pharmacology
Azithromycin - therapeutic use
Bacteriology
Biological and medical sciences
Community-Acquired Infections - drug therapy
Drug Resistance, Bacterial - genetics
Female
Fundamental and applied biological sciences. Psychology
Genetic Variation - genetics
Humans
Microbiology
Middle Aged
Pathogenicity, virulence, toxins, bacteriocins, pyrogens, host-bacteria relations, miscellaneous strains
Pneumonia - drug therapy
RNA, Ribosomal, 23S - genetics
Sequence Analysis, DNA
Streptococcus pneumoniae - drug effects
Streptococcus pneumoniae - genetics
Treatment Failure
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Summary:In this report, we describe an azithromycin treatment failure in community-acquired pneumonia. During the first three days of azithromycin, the patient’s symptoms worsened, and she was subsequently admitted to the hospital. Blood cultures were positive for a penicillin-susceptible, macrolide-resistant S. pneumoniae. DNA sequencing revealed an A2059G mutation in domain V of the 23S rRNA. To our knowledge, this is the first clinical report of an azithromycin failure in the treatment of S. pneumoniae resistant to macrolides by this mechanism.
ISSN:0732-8893
1879-0070
DOI:10.1016/S0732-8893(02)00379-6