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[Pneumococcus: an unusual agent of maternal-fetal infection]
M Strobel1, J M Rosenthal, C Adjide
1Service de Maladies infectieuses, CHU de Pointe-à-Pitre, Guadeloupe.
Background:
Since the advent of antibiotics, Streptococcus pneumoniae has become a very unusual agent of materno-fetal infection. We report two cases.
Case Reports:
In case n(o) 1, early neonatal meningitis was caused by a penicillin-resistant strain. In case n(o) 2, the mother developed meningitis 16 days after delivery. In both cases, premature rupture of the membranes in otherwise asymptomatic mothers was the initial event and outcome was favorable under amoxicillin alone. The pneumococci were easily recovered fom placental, amniotic and neonatal samples, less easily from the maternal samples.
Discussion:
The increasing prevalence of penicillin-resistant pneumococci is an emerging problem of real concern. It might increase the very low present incidence of pneumococcal neonatal materno-fetal infection which is a particularly serious infection with up to 60% neonatal mortality. Any type of S. pneumoniae infection, or even colonization, occurring in the peripartum should prompt adequate treatment and suggests considering first line vancomycin for the newborn.
Insights
Two cases of materno-fetal infection caused by Streptococcus pneumoniae highlight the growing threat of antibiotic resistance. Early diagnosis and treatment are crucial for favorable outcomes in these rare but serious neonatal infections.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Infectious Diseases
Background:
- Streptococcus pneumoniae is an uncommon cause of materno-fetal infections.
- The increasing prevalence of penicillin-resistant strains poses a significant public health concern.
Observation:
- Two cases of Streptococcus pneumoniae materno-fetal infection are presented.
- Both cases involved premature rupture of membranes in asymptomatic mothers.
- Penicillin-resistant Streptococcus pneumoniae was identified in neonatal meningitis and maternal meningitis.
Findings:
- Favorable outcomes were achieved with amoxicillin treatment in both cases.
- Pneumococci were readily isolated from placental, amniotic, and neonatal samples.
Implications:
- Rising penicillin resistance may increase the incidence of severe neonatal pneumococcal infections.
- Peripartum Streptococcus pneumoniae infections warrant prompt and adequate treatment.
- Vancomycin should be considered as a first-line treatment for newborns with suspected pneumococcal infections.