Clinical observation of meningitis caused by penicillin-susceptible and -non-susceptible Streptococcus pneumoniae in Taiwanese children.
OBJECTIVE
To compare differences between clinical features and outcome in bacterial meningitis caused by penicillin-susceptible Streptococcus pneumoniae (PSSP) with that caused by penicillin-non-susceptible Streptococcus pneumoniae (PNSP).


METHODS
All patients <18 yrs hospitalised with pneumococcal meningitis between January 1984 and December 2002 at Chang Gung Children's Hospital, Taipei were reviewed retrospectively.


RESULTS
There were 28 PNSP (63.6%) and 16 PSSP cases of meningitis eligible for the study. The incidence of PNSP meningitis increased significantly over the 8-yr period (p = 0.007). Age <4 yrs (78.6% vs 50%), a lower initial white blood count (mean 11.7 vs 19.9 x10(9)/L), admission to the intensive care unit (70.4% vs 50%) and mortality (28.6% vs 6.3%) were more common in the PNSP group. However, the only significant finding was a lower proportion of polymorphic neutrophils in the CSF of the PNSP meningitis group (p = 0.04).


CONCLUSIONS
There was an increase in PNSP isolates from patients with meningitis over the 8-yr study period. No major differences were observed in clinical or laboratory features or outcome between the PSSP and PNSP groups.
Chen
Shih-Hsiang
SH
Division of Pediatrics, Chang Gung Children's Hospital, Taipei, Taiwan, Republic of China.
Yen
Meng Hsiu
MH
Chiu
Cheng-Hsun
CH
Yan
Dah-Chin
DC
Hsu
Chih-Yi
CY
Lin
Tzou-Yien
TY
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008586:Meningitis, Pneumococcal / Q000188:drug therapy / Q000382:microbiology*; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance; D011379:Prognosis; D012189:Retrospective Studies; D013296:Streptococcus pneumoniae / Q000187:drug effects*; D016896:Treatment Outcome