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Updated: Aug 5, 2026

Characterization of Inflammatory Responses During Intranasal Colonization with Streptococcus pneumoniae
Published on: January 17, 2014
[Pneumococcal meningitis: epidemiological, clinical and bacteriological characteristics]
J A Soult Rubio1, C Rangel Pineda, M Muñoz Sáez
1Unidad de Cuidados Intensivos Pediátricos. Hospital Infantil Universitario Virgen del Rocío. Sevilla. jasoult@terra.es
Objective:
To analyze the epidemiological and clinical features of pneumococcal meningitis.
Patients And Methods:
We performed a retrospective study of 53 cases of pneumococcal meningitis that occurred in 47 pediatric patients in our hospital between 1977 and 2000. Four children had recurrent meningitis. In all patients Streptococcus pneumoniae was isolated from cerebrospinal fluid culture. The epidemiological, bacteriological and clinical characteristics were studied.
Results:
Pneumococcal meningitis represented 6 % of bacterial meningitis in our environment with 2-3 cases registered per year. Seventy-two percent of cases occurred in winter and spring. The age of affected children was between 1 month and 13 years. Sixty-five percent of children older than 2 years had a predisposing disease. Penicillin-resistant strains were detected in 1990 and cefotaxime-resistant strains were isolated in 1994. Seven children (13 %) had severe neurological sequels and two (4 %) died.
Conclusions:
Pneumococcal meningitis produces higher morbidity and mortality than other types of bacterial meningitis. The disease usually affects children younger than 2 years and older children with a predisposing disease. In the last few years, the importance of pneumococcal meningitis has increased due to the lower incidence of other types of bacterial meningitis. Because of beta-lactam resistant strains, initial empirical treatment should include vancomycin. The above data suggest the advisability of the generalized use of heptavalent pneumococcal conjugate vaccine in the pediatric population in our environment.
Insights
Pneumococcal meningitis is more severe than other bacterial meningitis types, affecting young children and those with predisposing conditions. Increased resistance necessitates vancomycin treatment and suggests widespread use of the pneumococcal conjugate vaccine.
Area of Science:
- Pediatric infectious diseases
- Epidemiology of meningitis
- Bacteriology of Streptococcus pneumoniae
Context:
- Retrospective analysis of 53 pneumococcal meningitis cases in pediatric patients (1977-2000).
- Streptococcus pneumoniae confirmed via cerebrospinal fluid culture in all cases.
- Identified 4 cases of recurrent meningitis among the pediatric cohort.
Purpose:
- To analyze the epidemiological and clinical features of pneumococcal meningitis.
- To investigate the characteristics of Streptococcus pneumoniae infections in children.
- To evaluate the impact of antibiotic resistance on treatment and outcomes.
Summary:
- Pneumococcal meningitis accounted for 6% of bacterial meningitis, with 2-3 annual cases, predominantly in winter/spring.
- Affected children ranged from 1 month to 13 years; 65% of those over 2 years had predisposing conditions.
- Antibiotic resistance emerged (penicillin-resistant 1990, cefotaxime-resistant 1994), leading to severe neurological sequelae in 13% and mortality in 4%.
Impact:
- Pneumococcal meningitis exhibits higher morbidity and mortality compared to other bacterial meningitis types.
- The disease primarily affects children under 2 years and older children with comorbidities.
- Rising antibiotic resistance and decreasing incidence of other bacterial meningitis types underscore the importance of pneumococcal meningitis. Initial empirical treatment should include vancomycin due to beta-lactam resistance. Generalized use of the heptavalent pneumococcal conjugate vaccine is recommended for the pediatric population.
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