[Rhône-Alpes observatory of Streptococcus pneumoniae in 1999: 35 cases of meningitis]

Pathol Biol (Paris). 2002 Dec;50(10):595-8. doi: 10.1016/s0369-8114(02)00356-5.
[Article in French]

Abstract

In 1999, in Rhône-Alpes region, in a survey of resistance to antibiotics of Streptococcus pneumoniae, 35 cases of meningitis were observed. A retrospectic questionnary was sent to each participant. MICs to Penicillin, Amoxicillin and Cefotaxime were determined with ATB-PNEUMO gallery or E-test and by disk diffusion for the other antibiotics. The results were interpreted according to the recommendations of the CA-SFM. Mean age was 38.1 years (range : 1 month -78 years) and sex-ratio 2/5. Eight patients had previously received antibiotics, 22 patients had risk factors and 23 were transferred in intensive care unit. The patients received C3G + glycopeptide in 15 of 16 children and in 13/19 adults according to the consensus recommendations. Diagnostic was made on the direct examination of CSF in 83%, and blood cultures was positive in 74.3% of cases. The percentage of PRP was 48.6% with 17.1% of intermediate-amoxicilline and 14.3% intermediate-cefotaxime strains. Resistance to trimethoprim-sulfamethoxazole was 45.7%, to chloramphenicol 30% and to fosfomycin 6.9%. All the strains were susceptible to rifampicin and vancomycin. Among the 17 PRP strains, 7 were belonging to serotype 6 (6 in children). The clinical outcome was fatal in 7 male cases (20%), without risk factors in 3 children and 6 of 7 strains were susceptible to penicillin. Six patients (17%) had auditive and/or neurologic sequellaes. This study shows that nearly 50% of strains isolated in meningitis, in Rhône-Alpes region, were not susceptible to penicillin, and confirms the frequency of sequellaes while the mortality is not related with the resistance of strains to the antibiotics.

Publication types

  • English Abstract

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amoxicillin / administration & dosage
  • Cefotaxime / administration & dosage
  • Child
  • Child, Preschool
  • Chloramphenicol
  • Drug Resistance, Microbial
  • Female
  • Fosfomycin
  • France / epidemiology
  • Humans
  • Infant
  • Male
  • Meningitis, Pneumococcal / diagnosis
  • Meningitis, Pneumococcal / drug therapy
  • Meningitis, Pneumococcal / epidemiology*
  • Microbial Sensitivity Tests
  • Middle Aged
  • Penicillins / administration & dosage
  • Retrospective Studies
  • Rifampin / administration & dosage
  • Surveys and Questionnaires
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Vancomycin / administration & dosage

Substances

  • Penicillins
  • Fosfomycin
  • Chloramphenicol
  • Vancomycin
  • Amoxicillin
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Cefotaxime
  • Rifampin