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Article: Fluoroquinolone-resistant group B streptococci in acute exacerbation of chronic bronchitis.(LETTERS)(Letter to the editor)
- Article from:
- Emerging Infectious Diseases
- Article date:
- February 1, 2008
- Author:
CopyrightCOPYRIGHT 2008 U.S. National Center for Infectious Diseases. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)
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To the Editor: Fluoroquinolones (FQs) that are active against streptococcal species (e.g., levofloxacin and moxifloxacin) have been recommended by numerous national health authorities and international organizations for treating acute exacerbations of chronic bronchitis and pneumonia in adults (1). However, use of these antimicrobial drugs for treating community-acquired infections has led to an increase in FQ-resistant strains in bacteria such as Streptococcus pneumoniae. Group B streptococci (GBS, e.g., S. agalactiae) are the leading cause of invasive infections (pneumonia, septicemia, and meningitis) in neonates. GBS are also associated with bacteremia, endocarditis, ...
<10) obtained 8 days apart. This patient was treated for 2 weeks with levofloxacin, 750 mg/day, for acute exacerbation of chronic bronchitis. No other relevant respiratory bacterial pathogens were present in these samples. GBS CNR0717, a capsular serotype IV strain, was suspected to have reduced susceptibility to FQs because no inhibition zone was observed around disks containing norfloxacin and pefloxacin disks, and reduced diameters were observed around disks containing ciprofloxacin and levofloxacin. Antibiograms were performed according to recommendations of the Clinical and Laboratory Standards Institute (3) on Mueller Hinton agar (Bio-Rad, Marnes la Coquette, France) supplemented with 5% horse blood. This strain was susceptible to all other antimicrobial drugs usually active against GBS (penicillin, erythromycin, clindamycin, tetracycline, rifampicin, vancomycin) and showed low-level resistance against aminoglycosides. MICs for 6 FQs (Table) indicate that GBS CNR0717 was highly resistant to pefloxacin and norftoxacin, with MICs>