Objective: To evaluate the susceptibility to antibiotics of Streptococcus pneumoniae isolated from cerebrospinal fluid of children with meningitis. To describe and compare the clinical and microbiological characteristics, treatment 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.
Results: 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 cefotaxime. The only associated factors (by Fisher's exact test) associated to resistance were: previous use of antibiotics (p = 0.2), underlying disease (p < 0.001). Course of illness and clinical course were similar for children infected with penicillin or cefotaxime susceptible, vs. non-susceptible strains.
Conclusions: Current levels of S. pneumoniae resistance to penicillin and cephalosporin are not associated to an increase in mortality in children with meningitis.