Streptococcus pneumoniae meningitis resistant to penicillin clinical and microbiological characteristics.

Objective. To evaluate the susceptibility to antibiotics of Streptococcus p neumoniae isolated from cerebrospinal fluid of children with meningitis. To describe and compare the clinical and microbiological characteristics, tre atment and outcome among children infected with strains either susceptible or resistant to penicillin and cephalosporin. Material and methods. A total of 38 children with pneumococcal meningitis were prospectively enrolled in the Institutional Surveillance Program for Pneumococcal Infections during 1994-1998. Clinical and laboratory data were collected by chart review. Res ults. Of the 38 children, 24 (63%) were less than 2 years of age, 11 (28.9% ) had drug-resistant S. pneumoniae, 18.4% had intermediate resistance, 10.5 % high level resistance and 2.6% also showed high level resistance to cefot axime. The only associated factors (by Fisher's exact test) associated to r esistance were: previous use of antibiotics (P=0.2), underlying disease (p< 0.001). Course of illness and clinical course were similar for children inf ected with penicillin or cefotaxime susceptible, vs. non-susceptible strain s. Conclusions. Current levels of S. pneumoniae resistance to penicillin an d cephalosporin are not associated to an increase in mortality in children with meningitis.