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Updated: Aug 18, 2026

Experimental Human Pneumococcal Carriage
07:47

Experimental Human Pneumococcal Carriage

Published on: February 15, 2013

Sequential bacteriological findings in the cerebrospinal fluid of Nigerian patients with pneumococcal meningitis

B M Greenwood, M Hassan-King, P G Cleland

    The Journal of Infection
    |January 1, 1986
    PubMed

    Insights

    In pneumococcal meningitis patients treated with penicillin, bacteria persisted in cerebrospinal fluid (CSF) despite high drug levels. This persistence may explain poorer outcomes compared to meningococcal meningitis.

    Area of Science:

    • Infectious Diseases
    • Neurology
    • Pharmacology

    Background:

    • Pneumococcal meningitis is a serious infection of the central nervous system.
    • Penicillin is a primary antibiotic for treating bacterial meningitis.
    • Understanding treatment efficacy and bacterial clearance is crucial for patient prognosis.

    Purpose of the Study:

    • To investigate the bacteriological response in cerebrospinal fluid (CSF) of patients with pneumococcal meningitis receiving high-dose penicillin.
    • To compare bacterial persistence in pneumococcal meningitis with known clearance rates in meningococcal meningitis.

    Main Methods:

    • Sequential CSF sampling and bacterial cultures were performed on 28 patients.
    • Patients received high-dose penicillin for two weeks.
    • Penicillin concentrations in CSF were measured and compared to minimum inhibitory concentrations.

    Main Results:

    • Bacteria were isolated from CSF up to 48 hours after treatment initiation in 4 patients.
    • One patient had positive CSF cultures 48 hours after treatment cessation.
    • Bacterial persistence occurred despite CSF penicillin levels exceeding the minimum inhibitory concentration.

    Conclusions:

    • High-dose penicillin treatment did not ensure rapid bacterial clearance in all pneumococcal meningitis cases.
    • Persistent bacteria in CSF may contribute to the less favorable prognosis of pneumococcal meningitis versus meningococcal meningitis.
    • Further research into treatment strategies for persistent pneumococcal meningitis is warranted.

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