Abstract
Despite the use of levofloxacin prophylaxis during the neutropenic period after autologous peripheral blood stem cell transplantation, viridans group (VG) streptococcal bacteremia developed in 6 (16.2%) of 37 patients who underwent transplantation between 1 January and 25 February 2001 at the Mayo Clinic in Rochester, Minnesota. All 6 patients presented with fever and mucositis after a mean of 4.5 days of neutropenia, and 3 developed septic shock. All 6 VG streptococcal isolates from these patients exhibited distinct patterns on pulsed-field gel electrophoresis. All isolates had diminished susceptibility to levofloxacin, 5 to gatifloxacin, and 4 to moxifloxacin. Quinolone resistance was associated with mutations in the quinolone resistance-determining region of GyrA and (for 1 isolate) of ParC. The use of levofloxacin may select VG streptococci with diminished susceptibility to levofloxacin and other quinolones with enhanced activity against gram-positive organisms and, therefore, may not be optimal for preventing VG streptococcal bacteremia in neutropenic patients.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1469-1474 |
| Number of pages | 6 |
| Journal | Clinical Infectious Diseases |
| Volume | 34 |
| Issue number | 11 |
| DOIs | |
| State | Published - Jun 1 2002 |
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ASJC Scopus subject areas
- Immunology
Cite this
Bacteremia due to viridans group streptococi with diminished susceptibility to levofloxacin among neutropenic patients receiving levofloxacin prophylaxis. / Razonable, Raymund R; Litzow, Mark R; Khaliq, Yasmin; Piper, Kerryl E.; Rouse, Mark S.; Patel, Robin.
In: Clinical Infectious Diseases, Vol. 34, No. 11, 01.06.2002, p. 1469-1474.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Bacteremia due to viridans group streptococi with diminished susceptibility to levofloxacin among neutropenic patients receiving levofloxacin prophylaxis
AU - Razonable, Raymund R
AU - Litzow, Mark R
AU - Khaliq, Yasmin
AU - Piper, Kerryl E.
AU - Rouse, Mark S.
AU - Patel, Robin
PY - 2002/6/1
Y1 - 2002/6/1
N2 - Despite the use of levofloxacin prophylaxis during the neutropenic period after autologous peripheral blood stem cell transplantation, viridans group (VG) streptococcal bacteremia developed in 6 (16.2%) of 37 patients who underwent transplantation between 1 January and 25 February 2001 at the Mayo Clinic in Rochester, Minnesota. All 6 patients presented with fever and mucositis after a mean of 4.5 days of neutropenia, and 3 developed septic shock. All 6 VG streptococcal isolates from these patients exhibited distinct patterns on pulsed-field gel electrophoresis. All isolates had diminished susceptibility to levofloxacin, 5 to gatifloxacin, and 4 to moxifloxacin. Quinolone resistance was associated with mutations in the quinolone resistance-determining region of GyrA and (for 1 isolate) of ParC. The use of levofloxacin may select VG streptococci with diminished susceptibility to levofloxacin and other quinolones with enhanced activity against gram-positive organisms and, therefore, may not be optimal for preventing VG streptococcal bacteremia in neutropenic patients.
AB - Despite the use of levofloxacin prophylaxis during the neutropenic period after autologous peripheral blood stem cell transplantation, viridans group (VG) streptococcal bacteremia developed in 6 (16.2%) of 37 patients who underwent transplantation between 1 January and 25 February 2001 at the Mayo Clinic in Rochester, Minnesota. All 6 patients presented with fever and mucositis after a mean of 4.5 days of neutropenia, and 3 developed septic shock. All 6 VG streptococcal isolates from these patients exhibited distinct patterns on pulsed-field gel electrophoresis. All isolates had diminished susceptibility to levofloxacin, 5 to gatifloxacin, and 4 to moxifloxacin. Quinolone resistance was associated with mutations in the quinolone resistance-determining region of GyrA and (for 1 isolate) of ParC. The use of levofloxacin may select VG streptococci with diminished susceptibility to levofloxacin and other quinolones with enhanced activity against gram-positive organisms and, therefore, may not be optimal for preventing VG streptococcal bacteremia in neutropenic patients.
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UR - http://www.scopus.com/inward/citedby.url?scp=0036604492&partnerID=8YFLogxK
U2 - 10.1086/340352
DO - 10.1086/340352
M3 - Article
C2 - 12015693
AN - SCOPUS:0036604492
VL - 34
SP - 1469
EP - 1474
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 11
ER -