title: Acute bacterial meningitis caused by Streptococcus pneumoniae resistant to the antimicrobian agents and their serotypes.
abstract: The main objectives of this study are to evaluate the resistance rates of Streptococcus pneumonia to penicillin G, ceftriaxone and vancomycin in patients with meningitis; to analyze possible risk factors to the antimicrobian resistance; to describe the serotypes detected and to suggest an initial empirical treatment for meningitis. The sensitiveness and serotypes of all isolated S. pneumoniae of patients with acute bacterial meningitis received by the Paraná State Central Laboratory from April 2001 to august 2002 have been evaluated. One hundred S. pneumoniae have been isolated, of which 15% were resistant to penicillin, 1% to cephalosporin and 0% to vancomycin. The serotypes most found were 14 (19%), 3 and 23F (10% each). When only the resistant serotypes were analyzed, the most prevalent was the 14 with 44%. The risk factors found in relation to the S. pneumoniae resistance were: age under one year old (p=0.01) and previous use of antibiotic (p=0.046). The resistance rates found, which were moderate to penicillin, low to cephalosporin and neutral to vancomycin, suggest the isolated use of a 3rd generation cephalosporin as an initial empirical therapy for the treatment of acute bacterial meningitis with a communitarian background.
authors.affiliation: Pediatric Service, Hospital de Clinicas, Federal University of Paraná, Curitiba, PR, Brazil. andrea@sms.curitiba.pr.gov.br
authors.forename: Andrea Maciel de Oliveira
authors.initials: AM
authors.lastname: Rossoni
authors.forename: Libera Maria
authors.initials: LM
authors.lastname: Dalla Costa
authors.forename: Denize Bonato
authors.initials: DB
authors.lastname: Berto
authors.forename: Sônia Santos
authors.initials: SS
authors.lastname: Farah
authors.forename: Marilene
authors.initials: M
authors.lastname: Gelain
authors.forename: Maria Cristina de Cunto
authors.initials: MC
authors.lastname: Brandileone
authors.forename: Vitor Hugo Mariano
authors.initials: VH
authors.lastname: Ramos
authors.forename: Sergio Monteiro de
authors.initials: SM
authors.lastname: Almeida
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001938:Brazil; D002511:Cephalosporins / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008586:Meningitis, Pneumococcal / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D012307:Risk Factors; D012703:Serotyping; D018709:Statistics, Nonparametric; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D014640:Vancomycin / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D010406:Penicillins; D014640:Vancomycin