[Rhône-Alpes observatory of Streptococcus pneumoniae in 1999: 35 cases of meningitis].
In 1999, in Rhône-Alpes region, in a survey of resistance to antibiotics of Streptococcus pneumoniae, 35 cases of meningitis were observed. A retrospectic questionnary was sent to each participant. MICs to Penicillin, Amoxicillin and Cefotaxime were determined with ATB-PNEUMO gallery or E-test and by disk diffusion for the other antibiotics. The results were interpreted according to the recommendations of the CA-SFM. Mean age was 38.1 years (range : 1 month -78 years) and sex-ratio 2/5. Eight patients had previously received antibiotics, 22 patients had risk factors and 23 were transferred in intensive care unit. The patients received C3G + glycopeptide in 15 of 16 children and in 13/19 adults according to the consensus recommendations. Diagnostic was made on the direct examination of CSF in 83%, and blood cultures was positive in 74.3% of cases. The percentage of PRP was 48.6% with 17.1% of intermediate-amoxicilline and 14.3% intermediate-cefotaxime strains. Resistance to trimethoprim-sulfamethoxazole was 45.7%, to chloramphenicol 30% and to fosfomycin 6.9%. All the strains were susceptible to rifampicin and vancomycin. Among the 17 PRP strains, 7 were belonging to serotype 6 (6 in children). The clinical outcome was fatal in 7 male cases (20%), without risk factors in 3 children and 6 of 7 strains were susceptible to penicillin. Six patients (17%) had auditive and/or neurologic sequellaes. This study shows that nearly 50% of strains isolated in meningitis, in Rhône-Alpes region, were not susceptible to penicillin, and confirms the frequency of sequellaes while the mortality is not related with the resistance of strains to the antibiotics.
Chomarat
M
M
Laboratoire de microbiologie, CHU Lyon-Sud, 69310 Pierre-Bénite, France. monique.chomarat@chu-lyon.fr
Fredenucci
I
I
Barbé
G
G
Boucaud-Maitre
Y
Y
Boyer
M
M
Carricajo
A
A
Célard
M
M
Clergeau
P
P
Croizé
J
J
Delubac
F
F
Fèvre
D
D
Fuhrmann
C
C
Gilles
Y
Y
Gravagna
B
B
Helfre
M
M
Letouzey
M N
MN
Lelièvre
H
H
Mandjee
A
A
Marchal
M F
MF
Marthelet
P
P
Meley
R
R
Perrier-Gros-Claude
J D
JD
Bercion
R
R
Reverdy
M E
ME
Ros
A
A
Roure
C
C
Sabot
O
O
Smati
S
S
Thierry
J
J
Tixier
A
A
Tous
J
J
Verger
P
P
Zaoui
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage; D002439:Cefotaxime / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D002701:Chloramphenicol; D004352:Drug Resistance, Microbial; D005260:Female; D005578:Fosfomycin; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008586:Meningitis, Pneumococcal / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010406:Penicillins / Q000008:administration & dosage; D012189:Retrospective Studies; D012293:Rifampin / Q000008:administration & dosage; D011795:Surveys and Questionnaires; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014640:Vancomycin / Q000008:administration & dosage
D010406:Penicillins; D005578:Fosfomycin; D002701:Chloramphenicol; D014640:Vancomycin; D000658:Amoxicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D002439:Cefotaxime; D012293:Rifampin