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

Assaf MizrahiJean-Christophe MarvaudB PilmisJ C Nguyen VanC CouzigouC BruelN EngrandA Le MonnierT Lambert
Published in: Antimicrobial agents and chemotherapy (2020)
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.
Keyphrases
  • cerebrospinal fluid
  • binding protein
  • heart failure
  • high dose
  • low dose
  • left ventricular
  • catheter ablation
  • brain injury
  • blood brain barrier
  • subarachnoid hemorrhage
  • solid phase extraction