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Meningitis from a pneumococcus moderately resistant to penicillin

JAMA
|April 20, 1979
PubMed

Insights

Penicillin-resistant pneumococci strains were found in three children in 1978, including one with meningitis who relapsed. Routine screening for pneumococcal penicillin resistance is advised.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Penicillin has been a cornerstone treatment for pneumococcal infections.
  • Emergence of antimicrobial resistance is a significant public health concern.

Observation:

  • Three pediatric patients at Children's Hospital of Pittsburgh yielded pneumococcal strains with moderate penicillin resistance in 1978.
  • One patient diagnosed with pneumococcal meningitis experienced a clinical relapse despite receiving high-dose intravenous penicillin G potassium.

Findings:

  • The recovered pneumococcal isolates exhibited intermediate resistance to penicillin.
  • Clinical outcomes in one severe case (meningitis) were suboptimal, suggesting treatment challenges posed by resistant strains.

Implications:

  • Highlights the early emergence of penicillin resistance in Streptococcus pneumoniae.
  • Underscores the critical need for ongoing surveillance and susceptibility testing of pneumococci.
  • Suggests potential limitations of standard penicillin therapy in the presence of emerging resistance patterns.

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