title: Clinical observation of meningitis caused by penicillin-susceptible and -non-susceptible Streptococcus pneumoniae in Taiwanese children.
abstract: 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.
authors.affiliation: Division of Pediatrics, Chang Gung Children's Hospital, Taipei, Taiwan, Republic of China.
authors.forename: Shih-Hsiang
authors.initials: SH
authors.lastname: Chen
authors.forename: Meng Hsiu
authors.initials: MH
authors.lastname: Yen
authors.forename: Cheng-Hsun
authors.initials: CH
authors.lastname: Chiu
authors.forename: Dah-Chin
authors.initials: DC
authors.lastname: Yan
authors.forename: Chih-Yi
authors.initials: CY
authors.lastname: Hsu
authors.forename: Tzou-Yien
authors.initials: TY
authors.lastname: Lin
mesh_terms: 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