title: [Recurring meningitis caused by Streptococcus pneumoniae during preventive penicillin therapy].
abstract: It is generally accepted, that Streptococcus pneumoniae is very sensitive to penicillin G; minimal inhibitory concentration (MIC) is normally about less than = 0.01 microgram/ml. Some years ago strains relatively resistant to penicillin (MIC 0.1 to 1.0 microgram/ml) were reported on. In 1977 strains isolated from blood and cerebrospinal fluid in South-Africa were found to have a higher resistance to penicillin (MIC 0.5-4 micrograms/ml). We report on an 6-year-old girl with septicemia and meningitis caused by a strain of S. pneumoniae relatively resistant to penicillin (MIC 0.5 microgram/ml). Aged 5 years the girl had a first meningitis caused by S. pneumoniae. The girl was then treated with penicillin (450,000 IU/d) to prevent a new infection. During this time the second meningitis caused by S. pneumoniae took place. In the agarose gel electrophoresis a plasmid was found (4.2 X 10(6) Dalton). No beta-lactamase-activity was detected (nitrocefin-test and acidimetric measurement). It is unlikely that there is a plasmid-dependent resistance to penicillin.
mesh_terms: D002648:Child; D004587:Electrophoresis, Agar Gel; D005260:Female; D006801:Humans; D008586:Meningitis, Pneumococcal / Q000188:drug therapy*; D008826:Microbial Sensitivity Tests; D010400:Penicillin G / Q000627:therapeutic use*; D010403:Penicillin Resistance; D011815:R Factors; D012008:Recurrence; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000235:genetics
chemical_list: D010400:Penicillin G
vernacular_title: Rezidivierende Meningitis durch Streptococcus pneumoniae unter Penicillin-Prophylaxe.