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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.
Insights
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.
Abstract:
Two infants with nephrotic syndrome who developed penicillin resistant pneumococcal peritonitis while receiving penicillin chemoprophylaxis are reported and the problems associated with prophylaxis against pneumococcal infection discussed. It is suggested that penicillin prophylaxis may be hazardous in an environment in which penicillin resistant pneumococci are prevalent.