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Clinical implication of extended-spectrum cephalosporin nonsusceptibility in Streptococcus pneumoniae meningitis

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Abstract

The clinical implication of extended-spectrum cephalosporin (ESC) resistance has been unclear in patients with Streptococcus pneumoniae meningitis (SPM). We collected the clinical data of 120 patients with SPM in 12 hospitals of the Republic of Korea. The clinical characteristics and outcomes of 23 ESC-nonsusceptible SPM episodes were compared to those of 97 ESC-susceptible episodes. Hospital acquisition, presence of other foci of pneumococcal infection, septic shock at initial presentation, or concomitant bacteremia were more commonly observed in ESC-nonsusceptible than ESC-susceptible SPM. Empiric antimicrobial therapy with vancomycin and ESC combination was very common in both groups. Although there was a tendency towards higher early fatality in ESC-nonsusceptible SPM (3-day mortality; 17.4 % vs. 4.4 %, p = 0.05), in-hospital mortality (26.1 % vs. 20.9 %, p = 0.59) and median length of hospital stay (20 days vs. 24 days, p = 0.34) did not differ between ESC-nonsusceptible and ESC-susceptible SPM.

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References

  1. John CC (1994) Treatment failure with use of a third-generation cephalosporin for penicillin-resistant pneumococcal meningitis: case report and review. Clin Infect Dis 18:188–193

    Article  PubMed  CAS  Google Scholar 

  2. Kaplan SL, Mason EO Jr (1998) Management of infections due to antibiotic-resistant Streptococcus pneumoniae. Clin Microbiol Rev 11:628–644

    PubMed  CAS  Google Scholar 

  3. Friedland IR, Paris M, Ehrett S, Hickey S, Olsen K, McCracken GH Jr (1993) Evaluation of antimicrobial regimens for treatment of experimental penicillin- and cephalosporin-resistant pneumococcal meningitis. Antimicrob Agents Chemother 37:1630–1636

    Article  PubMed  CAS  Google Scholar 

  4. American Academy of Pediatrics Committee on Infectious Diseases (1997) Therapy for children with invasive pneumococcal infections. Pediatrics 99:289–299

    Article  Google Scholar 

  5. Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM, Whitley RJ (2004) Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 39:1267–1284

    Article  PubMed  Google Scholar 

  6. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RMH, Sibbald WJ (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 101:1644–1655

    Article  PubMed  CAS  Google Scholar 

  7. Goldstein B, Giroir B, Randolph A; International Consensus Conference on Pediatric Sepsis (2005) International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med 6:2–8

    Article  PubMed  Google Scholar 

  8. Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness. A practical scale. Lancet 2:81–84

    Article  PubMed  CAS  Google Scholar 

  9. Clinical and Laboratory Standards Institute (CLSI) (2010) Performance standards for antimicrobial susceptibility testing; Twentieth informational supplement, M100-S20. CLSI, Wayne

    Google Scholar 

  10. Jennett B, Bond M (1975) Assessment of outcome after severe brain damage: a practical scale. Lancet 305:480–484

    Article  Google Scholar 

  11. Arditi M, Mason EO Jr, Bradley JS, Tan TQ, Barson WJ, Schutze GE, Wald ER, Givner LB, Kim KS, Yogev R, Kaplan SL (1998) Three-year multicenter surveillance of pneumococcal meningitis in children: clinical characteristics, and outcome related to penicillin susceptibility and dexamethasone use. Pediatrics 102:1087–1097

    Article  PubMed  CAS  Google Scholar 

  12. Buckingham SC, Mccullers JA, Luján-zilbermann J, Knapp KM, Orman KL, English BK (2001) Pneumococcal meningitis in children: relationship of antibiotic resistance to clinical characteristics and outcomes. Pediatr Infect Dis J 20:837–843

    Article  PubMed  CAS  Google Scholar 

  13. Fiore AE, Moroney JF, Farley MM, Harrison LH, Patterson JE, Jorgensen JH, Cetron M, Kolczak MS, Breiman RF, Schuchat A (2000) Clinical outcomes of meningitis caused by Streptococcus pneumoniae in the era of antibiotic resistance. Clin Infect Dis 30:71–77

    Article  PubMed  CAS  Google Scholar 

  14. Olivier C, Cohen R, Begué P, Floret D (2000) Bacteriologic outcome of children with cefotaxime- or ceftriaxone-susceptible and -nonsusceptible Streptococcus pneumoniae meningitis. Pediatr Infect Dis J 19:1015–1017

    Article  PubMed  CAS  Google Scholar 

  15. Brandt CT, Holm D, Liptrot M, Østergaard C, Lundgren JD, Frimodt-Møller N, Skovsted IC, Rowland IJ (2008) Impact of bacteremia on the pathogenesis of experimental pneumococcal meningitis. J Infect Dis 197:235–244

    Article  PubMed  Google Scholar 

  16. Carrol ED, Mankhambo LA, Corless C, Guiver M (2008) Bacteremia is associated with a worse outcome in pneumococcal meningitis. J Infect Dis 198:626–627

    Article  PubMed  Google Scholar 

  17. van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M (2004) Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med 351:1849–1859

    Article  PubMed  Google Scholar 

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Acknowledgment

This study was supported by grant 2011-389 from the Asan Institute of Life Sciences, Seoul, Korea.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea

    S.-H. Choi & J.-W. Chung

  2. Department of Internal Medicine, Inje University College of Medicine, Busan, Republic of Korea

    B.-N. Kim & Y. G. Kwak

  3. Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Republic of Korea

    T. H. Kim & E. J. Lee

  4. Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea

    E. J. Choo

  5. Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea

    M.-H. Jeon

  6. Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea

    M. S. Lee

  7. Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Republic of Korea

    I.-G. Bae

  8. Department of Internal Medicine, Cheongju St. Mary’s Hospital, Cheongju, Republic of Korea

    S.-R. Lee

  9. Department of Infectious Diseases, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea

    E. H. Song

  10. Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea

    J.-B. Jun

  11. Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    M.-N. Kim

  12. Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    S.-H. Kim, S.-O. Lee, Y. S. Kim, J. H. Woo & S.-H. Choi

  13. Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine and Center for Antimicrobial Resistance and Microbial Genetics, University of Ulsan, Seoul, 138-736, Republic of Korea

    S.-H. Choi

Authors
  1. S.-H. Choi
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  2. J.-W. Chung
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  3. B.-N. Kim
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  4. Y. G. Kwak
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  5. T. H. Kim
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  6. E. J. Lee
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  7. E. J. Choo
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  8. M.-H. Jeon
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  9. M. S. Lee
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  10. I.-G. Bae
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  11. S.-R. Lee
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  12. E. H. Song
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  13. J.-B. Jun
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  14. M.-N. Kim
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  15. S.-H. Kim
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  16. S.-O. Lee
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  17. Y. S. Kim
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  18. J. H. Woo
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  19. S.-H. Choi
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Correspondence to S.-H. Choi.

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Choi, SH., Chung, JW., Kim, BN. et al. Clinical implication of extended-spectrum cephalosporin nonsusceptibility in Streptococcus pneumoniae meningitis. Eur J Clin Microbiol Infect Dis 31, 3029–3034 (2012). https://doi.org/10.1007/s10096-012-1657-z

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  • DOI: https://doi.org/10.1007/s10096-012-1657-z

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