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Meningitis due to multiple-resistant penicillin- and cefotaxime-intermediate Streptococcus pneumoniae in a German

H Buxmann1, J Soerensen, U Koehl

  • 1Dept. of Neonatology, Johann Wolfgang Goethe University, Children's Hospital, Frankfurt am Main, Germany.

Infection
|January 22, 2004
PubMed

Insights

Penicillin-non-susceptible Streptococcus pneumoniae infections are rising globally. Even in low-resistance countries, this pathogen can cause severe meningitis, as seen in a German boy after travel to Spain.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Immunology

Background:

  • Increasing global incidence of penicillin-non-susceptible Streptococcus pneumoniae.
  • Regional variations in resistance levels, with Spain and France highly affected.
  • Importance of monitoring antibiotic resistance in immunocompromised patients.

Observation:

  • A 7-year-old German boy, post allogeneic bone marrow transplant (BMT), developed meningitis.
  • The causative agent was identified as penicillin- and cefotaxime-intermediate Streptococcus pneumoniae.
  • The infection occurred 5 weeks after a holiday in Spain, with symptoms appearing shortly before death.

Findings:

  • The patient, despite good remission status post-BMT and no graft-versus-host disease (GVHD), succumbed to the infection.
  • The meningitis was lethal, leading to death 2 days after symptom onset and 341 days post-BMT.
  • This case highlights the potential for severe outcomes even with intermediate resistance.

Implications:

  • Penicillin-non-susceptible S. pneumoniae must be considered a threat even in regions with historically low resistance prevalence.
  • Travel history is a critical factor in diagnosing infections in immunocompromised patients.
  • Enhanced surveillance and treatment strategies are needed for drug-resistant bacterial infections in vulnerable populations.

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