[Three interesting pediatric cases with penicillin-resistant Streptococcus pneumoniae infection]

Area of Science:

• Pediatric Infectious Diseases
• Microbiology
• Clinical Medicine

Background:

• Penicillin-resistant Streptococcus pneumoniae (PRSP) emerged in 1967 and has shown a significant global increase.
• Pediatric infections caused by PRSP are a growing concern, reaching up to 50% in some regions like Japan.
• Effective clinical strategies are needed to combat the rising prevalence of resistant pneumococcal strains.

Observation:

• Three distinct pediatric cases of penicillin G-resistant Streptococcus pneumoniae infections were documented.
• Case 1: Acute mastoiditis, a presentation less common than masked mastoiditis in recent clinical experience.
• Case 2: Meningitis with septicemia, initially presenting with normal cerebrospinal fluid findings.
• Case 3: Recurrent bronchitis in a pediatric patient with cerebral palsy.

Findings:

• Minimum inhibitory concentrations (MICs) for the isolated strains varied, with 0.25 µg/ml in the second case and 2.0 µg/ml in the first and third cases.
• The diverse clinical presentations underscore the varied manifestations of resistant pneumococcal infections in children.
• These cases provide valuable data on the susceptibility patterns of contemporary PRSP strains.

Implications:

• The findings offer crucial insights for clinicians managing pediatric patients with suspected or confirmed resistant pneumococcal infections.
• Understanding the clinical spectrum and susceptibility patterns of PRSP is vital for timely and appropriate treatment decisions.
• This case series contributes to the ongoing efforts to address the global challenge of antimicrobial resistance in Streptococcus pneumoniae.