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Multiply resistant pneumococcus causing meningitis: its epidemiology within a day-care centre
Lancet (London, England)
|October 10, 1981
Summary
A multiply-resistant Streptococcus pneumoniae strain caused meningitis in an infant. This resistant strain was found in 27% of children at the infant's daycare, highlighting the need for antimicrobial resistance surveillance.
Area of Science:
- Microbiology
- Infectious Diseases
- Epidemiology
Background:
- Meningitis in infants can be caused by Streptococcus pneumoniae.
- Antimicrobial resistance is a growing global health concern.
- Penicillin and chloramphenicol are common treatments for bacterial meningitis.
Observation:
- An 11-month-old infant presented with meningitis caused by a multidrug-resistant Streptococcus pneumoniae (serotype 6b).
- The infant's isolate showed high minimum inhibitory concentrations (MICs) for penicillin (1.0 µg/ml) and chloramphenicol (16 µg/ml).
- The infant initially did not respond to penicillin G but was successfully treated with ampicillin, chloramphenicol, and rifampicin.
Findings:
- The resistant strain was prevalent in the infant's daycare, with 27% of young children and 11% of older children and staff carrying the bacteria.
- A 33% carriage rate was observed in family contacts of colonized children.
- Antibiotic use in the preceding two months was associated with increased carriage of the resistant strain.
Implications:
- The emergence of multidrug-resistant Streptococcus pneumoniae in the US necessitates enhanced surveillance.
- Clinical microbiology laboratories should screen significant pneumococcal isolates for resistance to penicillin and chloramphenicol.
- Prompt identification and appropriate treatment are crucial for managing infections caused by resistant bacterial strains, especially in vulnerable populations like infants.