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[Epidemiologic, clinical and bacteriologic characteristics of pneumococcal meningitis in pediatric patients from
Long Davalos1, Yessica Terrazas1,2, Ana Quintana1,2
1Universidad Peruana Cayetano Heredia. Lima, Perú.
Insights
Pneumococcal meningitis is a deadly disease in young children, with most deaths occurring within 48 hours. Prompt diagnosis, management, and pneumococcal vaccination are critical for prevention and survival.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Pneumococcal meningitis remains a significant cause of mortality in children.
- Understanding its clinical features and antibiotic resistance patterns is crucial for effective treatment.
Purpose of the Study:
- To describe the clinical characteristics, lethality, antibiotic susceptibility, and serotype distribution of pneumococcal meningitis in pediatric patients in Lima, Peru.
Main Methods:
- A case series of 44 pneumococcal meningitis episodes in children under 16 years old.
- Data collected from two prospective, multicenter, passive surveillance studies in Lima, Peru (2006-2011).
Main Results:
- The overall case fatality rate was 32.6%, significantly higher in children under 2 years old.
- Malnutrition was associated with fatal cases. Antibiotic resistance was observed for penicillin, ceftriaxone, and chloramphenicol.
- Common serotypes included 6B, 14, 19F, and 23F, with 84.1% being PCV13 serotypes.
Conclusions:
- Pneumococcal meningitis is particularly lethal in infants, with rapid progression to death in many cases.
- Prompt diagnosis, management, and pneumococcal vaccination are essential to reduce mortality.
Objectives.:
To describe the clinical characteristics, lethality, antibiotic susceptibility, and serotype distribution of pneumococcal meningitis in pediatric patients in Lima, Peru.
Materials And Methods.:
A case series of pneumococcal meningitis in children less than 16 years of age from two prospective, multicenter, passive surveillance studies of invasive pneumococcal diseases held in Lima-Peru from 2006 to 2008 and 2009 to 2011.
Results.:
We report 44 pneumococcal meningitis episodes; 68.2% of them were in children less than 2 years old. The overall case fatality rate was 32.6%; 92.9% of fatal cases were in children less than 2 years of age (p<0.05). Malnutrition was associated with fatal cases (p<0.05). 64.3% of fatal cases died within the first two days. 41.9% of pneumococcal isolates were resistant to penicillin, 23.3% were intermediate resistant to ceftriaxone (none were highly resistant) and 9.3% were resistant to chloramphenicol. The most common serotypes were 6B, 14, 19F and 23F, which accounted for 68.3% of all strains; 84.1% of strains were PCV13 serotypes.
Conclusions.:
Pneumococcal meningitis continues to be a lethal disease, especially in children less than 2 years of age. Since almost two third of lethal cases lead to death within the first 48 hours, prompt diagnosis and management is critical, as well as assurance of immunization with pneumococcal vaccine.
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