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Penicillin resistant pneumococcal peritonitis in nephrotic syndrome
L S Milner1, F E Berkowitz, E Ngwenya
1Department of Paediatrics, University of Witwatersrand, Johannesburg, South Africa.
Archives of Disease in Childhood
|September 1, 1987
Summary
Penicillin prophylaxis for infants with nephrotic syndrome may be risky. Penicillin-resistant bacteria caused peritonitis in two infants despite chemoprophylaxis, highlighting potential hazards.
Area of Science:
- Pediatrics
- Infectious Diseases
- Nephrology
Background:
- Nephrotic syndrome increases infection risk in infants.
- Pneumococcal infections are a common concern in this population.
- Penicillin chemoprophylaxis is often used to prevent infections.
Observation:
- Two infants with nephrotic syndrome developed pneumococcal peritonitis.
- These infections occurred despite ongoing penicillin chemoprophylaxis.
- The causative pneumococcal strains were resistant to penicillin.
Findings:
- Penicillin chemoprophylaxis failed to prevent invasive pneumococcal disease in these cases.
- The prevalence of penicillin-resistant Streptococcus pneumoniae is a significant clinical challenge.
- This suggests limitations in current prophylactic strategies.
Implications:
- Penicillin prophylaxis may not be effective in areas with high rates of penicillin-resistant pneumococci.
- Alternative or adjunctive strategies for pneumococcal infection prevention are needed.
- Clinicians should consider local antimicrobial resistance patterns when prescribing prophylaxis.