[Pneumococcal meningitis: epidemiological, clinical and bacteriological characteristics].
OBJECTIVE
To analyze the epidemiological and clinical features of pneumococcal meningitis.


METHODS
We performed a retrospective study of 53 cases of pneumococcal meningitis that occurred in 47 pediatric patients in our hospital between 1977 and 2000. Four children had recurrent meningitis. In all patients Streptococcus pneumoniae was isolated from cerebrospinal fluid culture. The epidemiological, bacteriological and clinical characteristics were studied.


RESULTS
Pneumococcal meningitis represented 6 % of bacterial meningitis in our environment with 2-3 cases registered per year. Seventy-two percent of cases occurred in winter and spring. The age of affected children was between 1 month and 13 years. Sixty-five percent of children older than 2 years had a predisposing disease. Penicillin-resistant strains were detected in 1990 and cefotaxime-resistant strains were isolated in 1994. Seven children (13 %) had severe neurological sequels and two (4 %) died.


CONCLUSIONS
Pneumococcal meningitis produces higher morbidity and mortality than other types of bacterial meningitis. The disease usually affects children younger than 2 years and older children with a predisposing disease. In the last few years, the importance of pneumococcal meningitis has increased due to the lower incidence of other types of bacterial meningitis. Because of beta-lactam resistant strains, initial empirical treatment should include vancomycin. The above data suggest the advisability of the generalized use of heptavalent pneumococcal conjugate vaccine in the pediatric population in our environment.
Soult Rubio
J A
JA
Unidad de Cuidados Intensivos Pediátricos. Hospital Infantil Universitario Virgen del Rocío. Sevilla. jasoult@terra.es
Rangel Pineda
C
C
Muñoz Sáez
M
M
Parrilla Parrilla
J S
JS
Díaz Fernández
F
F
López Castilla
J D
JD
Tovaruela Santos
A
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008586:Meningitis, Pneumococcal / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D012189:Retrospective Studies