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Fluoroquinolones are an important part of therapy for multidrug-resistant TB. But how does their use affect the antimicrobial susceptibility of Streptococcus pneumoniae in a region with high rates of TB? To find out, investigators in South Africa assessed risk factors for invasive disease caused by fluoroquinolone-resistant S. pneumoniae in children.
Invasive pneumococcal infections were identified by active national surveillance from 2000 through 2006, supplemented by enhanced surveillance at 15 sentinel hospitals starting in 2003. Ofloxacin-resistant S. pneumoniae isolates were tested for levofloxacin susceptibility.
Among 19,404 isolates, 12 were found to be levofloxacin nonsusceptible (i.e., MIC ≥4 mg/L). Forty-four percent of the isolate…