Gonzaga C, Dever L L
Veterans Affairs New Jersey Health Care System, East Orange 07018, USA.
Microb Drug Resist. 1998 Spring;4(1):61-3. doi: 10.1089/mdr.1998.4.61.
The emergence of antibiotic resistance in Streptococcus pneumoniae poses a particular threat to HIV-infected patients. These patients are at increased risk of invasive pneumococcal disease and may respond poorly to pneumococcal vaccination. We describe an HIV-infected patient with recurrent aortic valve endocarditis due to the same serotype of S. pneumoniae (19A) despite appropriate treatment with penicillin and immunoprophylaxis. The pneumococcus responsible for the second episode of endocarditis was susceptible to cefotaxime (MIC of 0.06 microg/ml), but was no longer susceptible to penicillin (MIC of 0.25 microg/ml). The patient was treated successfully with 4 weeks of intravenous ceftriaxone.
肺炎链球菌中抗生素耐药性的出现对HIV感染患者构成了特殊威胁。这些患者发生侵袭性肺炎球菌疾病的风险增加，并且对肺炎球菌疫苗的反应可能较差。我们描述了一名HIV感染患者，尽管接受了青霉素的适当治疗和免疫预防，但仍因同一血清型的肺炎链球菌（19A）反复发生主动脉瓣心内膜炎。导致第二次心内膜炎发作的肺炎球菌对头孢噻肟敏感（最低抑菌浓度为0.06微克/毫升），但对青霉素不再敏感（最低抑菌浓度为0.25微克/毫升）。该患者接受了4周的静脉注射头孢曲松治疗并成功治愈。
