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Pneumococcal Antibiotic Resistance and Rates of Meningitis in Children
Author(s) -
Ryan Matthew W.,
Antonelli Patrick J.
Publication year - 2000
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200006000-00014
Subject(s) - streptococcus pneumoniae , meningitis , medicine , haemophilus influenzae , otitis , antibiotics , penicillin , pediatrics , antibiotic resistance , microbiology and biotechnology , surgery , biology
Objectives/Hypothesis Recent studies have shown alarmingly high rates of antibiotic resistance in Streptococcus pneumoniae isolates from patients with otitis media. A recent study has implicated resistant S pneumoniae for rising rates of acute mastoiditis. The purpose of this study was to determine whether S pneumoniae antibiotic resistance has similarly affected the rate of pediatric community‐acquired meningitis, the most common intracranial complication of otitis media. Study Design Retrospective chart review. Methods All cases of pediatric community‐acquired meningitis treated at an academic tertiary care hospital during a 10‐year period were reviewed, and meningitis rates were calculated as a proportion of yearly admissions. Results The overall rate of meningitis decreased linearly during the study period ( P = .001). This was largely because of a drop in the rate of Haemophilus influenzae meningitis ( P = .001), corresponding with the introduction of H influenzae type B vaccine. Annual rates of S pneumoniae meningitis did not change. Only one case of S pneumoniae meningitis was due to a highly penicillin‐resistant strain and isolates from four cases had intermediate sensitivity. Twenty‐four of 83 cases were associated with antecedent acute otitis media and 63% of these had been treated with antibiotics before admission. Otitis media, as a cause of meningitis, did not increase during the study period. Conclusion S pneumoniae is responsible for a greater proportion of cases of pediatric community‐acquired meningitis. However, this is because of a decline in the rate of H influenzae cases, not the rise in S pneumoniae antibiotic resistance.