title: Meningitis due to multiple-resistant penicillin- and cefotaxime-intermediate Streptococcus pneumoniae in a German child after bone marrow transplantation.
abstract: The incidence of infection with penicillin-non-susceptible Streptococcus pneumoniae is increasing rapidly worldwide. Spain and France are highly affected, whereas the level of penicillin resistance in Germany, Italy, The Netherlands and Scandinavia is low. We report a lethal episode of meningitis due to penicillin- and cefotaxime-intermediate S. pneumoniae in a 7-year-old, allogene bone marrow transplanted German boy, 5 weeks after a holiday in Spain. Three days prior to the infection the patient showed good performance status. He was in complete remission without signs of graft-versus-host disease (GVHD). He died on day 341 post bone marrow transplant (BMT), 2 days after the onset of meningitis. Penicillin-non-susceptible S. pneumoniae should be regarded as a potential infectious agent even in countries with a low prevalence of resistance.
authors.affiliation: Dept. of Neonatology, Johann Wolfgang Goethe University, Children's Hospital, Frankfurt am Main, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Buxmann
authors.forename: J
authors.initials: J
authors.lastname: Soerensen
authors.forename: U
authors.initials: U
authors.lastname: Koehl
authors.forename: D
authors.initials: D
authors.lastname: Schwabe
authors.forename: T
authors.initials: T
authors.lastname: Klingebiel
authors.forename: R R
authors.initials: RR
authors.lastname: Reinert
authors.forename: V
authors.initials: V
authors.lastname: Schaefer
mesh_terms: D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000379:methods; D002439:Cefotaxime / Q000494:pharmacology; D018550:Cephalosporin Resistance; D002648:Child; D018450:Disease Progression; D024901:Drug Resistance, Multiple, Bacterial; D017809:Fatal Outcome; D005858:Germany; D006801:Humans; D008297:Male; D008586:Meningitis, Pneumococcal / Q000188:drug therapy* / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000628:therapy; D018570:Risk Assessment; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification
chemical_list: D002439:Cefotaxime