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[Recurring meningitis caused by Streptococcus pneumoniae during preventive penicillin therapy]
Zentralblatt Fur Bakteriologie, Mikrobiologie, Und Hygiene. Series A, Medical Microbiology, Infectious Diseases, Virology, Parasitology
|September 1, 1986
Summary
This study reports a rare case of recurrent meningitis and septicemia in a child caused by penicillin-resistant Streptococcus pneumoniae. The resistance mechanism was investigated, with findings suggesting it is unlikely to be plasmid-dependent.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Medicine
Background:
- Streptococcus pneumoniae is typically highly sensitive to penicillin G, with minimal inhibitory concentrations (MICs) below 0.01 µg/ml.
- Reports of penicillin-resistant strains (MIC 0.1–1.0 µg/ml) have emerged over time.
- Higher penicillin resistance (MIC 0.5–4 µg/ml) in S. pneumoniae strains was noted in South Africa in 1977.
Observation:
- A case of a 6-year-old girl with septicemia and meningitis due to a penicillin-resistant S. pneumoniae strain (MIC 0.5 µg/ml) is presented.
- The patient experienced a second meningitis episode caused by S. pneumoniae while on penicillin prophylaxis for a previous infection.
- Agarose gel electrophoresis identified a plasmid (4.2 x 10^6 Daltons) in the causative strain.
Findings:
- No beta-lactamase activity was detected in the S. pneumoniae strain using nitrocefin and acidimetric tests.
- The presence of a plasmid was confirmed, but its role in penicillin resistance is considered unlikely.
- The specific mechanism of penicillin resistance in this S. pneumoniae strain remains undetermined.
Implications:
- This case highlights the emergence of penicillin-resistant Streptococcus pneumoniae and its potential clinical significance.
- Understanding novel resistance mechanisms is crucial for effective treatment of pneumococcal infections.
- Further research is needed to elucidate the genetic basis of penicillin resistance in such strains.