The pneumococcus: an unusual agent of materno-fetal infection

BACKGROUND: Since the advent of antibiotics, Streptococcus pneumoniae has b ecome a very unusual agent of maternofetal infection. We report two cases. CASE REPORTS: In case n(o) 1, early neonatal meningitis was caused by a pen icillin-resistant strain. In case n(o) 2, the mother developed meningitis 1 6 days after delivery. In both cases, premature rupture of the membranes in otherwise asymptomatic mothers was the initial evens and outcome was favor able under amoxicillin alone. The pneumococci were easily recovered from pl acental, amniotic and neonatal samples, less easily from the maternal sampl es. DISCUSSION: The increasing prevalence of penicillin-resistant pneumococci i s an emerging problem of real concern. It might increase the very low prese nt incidence of pneumococcal neonatal materno-fetal infection which is a pa rticularly serious infection with up to 60% neonatal mortality. Any type of S. pneumoniae infection, or even colonization, occurring in the peripartum should prompt adequate treatment and suggests considering first line vanco mycin for the newborn.