[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

Abstract

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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