Clinical Outcomes of Meningitis Caused by Streptococcus pneumoniae in the Era of Antibiotic Resistance
Limited data are available on clinical outcomes of meningitis due to cefotaxime-nonsusceptible Streptococcus pneumoniae. We analyzed data from 109 cases of pneumococcal meningitis in Atlanta, Baltimore, and San Antonio, which were identified through population-based active surveillance from November...
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| Veröffentlicht in: | Clinical infectious diseases 2000-01, Vol.30 (1), p.71-77 |
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| creator | Fiore, Anthony E. Moroney, John F. Farley, Monica M. Harrison, Lee H. Patterson, Jan E. Jorgensen, James H. Cetron, Martin Kolczak, Margarette S. Breiman, Robert F. Schuchat, Anne |
| description | Limited data are available on clinical outcomes of meningitis due to cefotaxime-nonsusceptible Streptococcus pneumoniae. We analyzed data from 109 cases of pneumococcal meningitis in Atlanta, Baltimore, and San Antonio, which were identified through population-based active surveillance from November 1994 to April 1996. Pneumococcal isolates from 9% of the cases were resistant to cefotaxime, and isolates from 11% had intermediate susceptibility. Children were more likely to have cephalosporin-nonsusceptible pneumococcal meningitis, but mortality was significantly higher among adults aged 18-64 years. Vancomycin was given upon admission to 29% of patients, and within 48 h of admission to 52%. Nonsusceptibility to cefotaxime was not associated with the following outcomes: increased mortality, prolonged length of hospital or intensive care unit (ICU) stay, requirement of intubation or oxygen, ICU care, discharge to another medical or long-term-care facility, or neurological deficit. Empirical use of vancomycin, current prevalence of drug-resistant S. pneumoniae, and degree of nonsusceptibility to cefotaxime may have influenced these findings. |
| doi_str_mv | 10.1086/313606 |
| format | Article |
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We analyzed data from 109 cases of pneumococcal meningitis in Atlanta, Baltimore, and San Antonio, which were identified through population-based active surveillance from November 1994 to April 1996. Pneumococcal isolates from 9% of the cases were resistant to cefotaxime, and isolates from 11% had intermediate susceptibility. Children were more likely to have cephalosporin-nonsusceptible pneumococcal meningitis, but mortality was significantly higher among adults aged 18-64 years. Vancomycin was given upon admission to 29% of patients, and within 48 h of admission to 52%. Nonsusceptibility to cefotaxime was not associated with the following outcomes: increased mortality, prolonged length of hospital or intensive care unit (ICU) stay, requirement of intubation or oxygen, ICU care, discharge to another medical or long-term-care facility, or neurological deficit. Empirical use of vancomycin, current prevalence of drug-resistant S. pneumoniae, and degree of nonsusceptibility to cefotaxime may have influenced these findings.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1086/313606</identifier><identifier>PMID: 10619736</identifier><identifier>CODEN: CIDIEL</identifier><language>eng</language><publisher>Chicago, IL: The University of Chicago Press</publisher><subject>Adolescent ; Adult ; Age Distribution ; Age groups ; Aged ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Bacterial diseases ; Bacterial diseases of the nervous system. Bacterial myositis ; Biological and medical sciences ; Cefotaxime - pharmacology ; Cephalosporin Resistance ; Cephalosporins - pharmacology ; Child ; Child, Preschool ; Children ; Clinical Articles ; Corticosteroids ; Female ; Health outcomes ; Hospital admissions ; Human bacterial diseases ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infectious diseases ; Intensive care units ; Male ; Medical sciences ; Meningitis, Pneumococcal - drug therapy ; Meningitis, Pneumococcal - epidemiology ; Meningitis, Pneumococcal - microbiology ; Meningitis, Pneumococcal - pathology ; Middle Aged ; Mortality ; Pneumococcal meningitis ; Population Surveillance ; Risk Factors ; Streptococcus pneumoniae ; Streptococcus pneumoniae - drug effects ; USA, Georgia, Atlanta ; USA, Maryland, Baltimore ; USA, Texas, San Antonio ; Vancomycin - therapeutic use</subject><ispartof>Clinical infectious diseases, 2000-01, Vol.30 (1), p.71-77</ispartof><rights>Copyright 2000 The Infectious Diseases Society of America</rights><rights>2000 by the Infectious Diseases Society of America 2000</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c452t-782722095025952a777fcf728cacbbc1597a35ef858d56331c6c625e2d030ce93</citedby><cites>FETCH-LOGICAL-c452t-782722095025952a777fcf728cacbbc1597a35ef858d56331c6c625e2d030ce93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/4482125$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/4482125$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,780,784,803,4024,27923,27924,27925,58017,58250</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1272955$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10619736$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fiore, Anthony E.</creatorcontrib><creatorcontrib>Moroney, John F.</creatorcontrib><creatorcontrib>Farley, Monica M.</creatorcontrib><creatorcontrib>Harrison, Lee H.</creatorcontrib><creatorcontrib>Patterson, Jan E.</creatorcontrib><creatorcontrib>Jorgensen, James H.</creatorcontrib><creatorcontrib>Cetron, Martin</creatorcontrib><creatorcontrib>Kolczak, Margarette S.</creatorcontrib><creatorcontrib>Breiman, Robert F.</creatorcontrib><creatorcontrib>Schuchat, Anne</creatorcontrib><title>Clinical Outcomes of Meningitis Caused by Streptococcus pneumoniae in the Era of Antibiotic Resistance</title><title>Clinical infectious diseases</title><addtitle>Clinical Infectious Diseases</addtitle><addtitle>Clinical Infectious Diseases</addtitle><description>Limited data are available on clinical outcomes of meningitis due to cefotaxime-nonsusceptible Streptococcus pneumoniae. We analyzed data from 109 cases of pneumococcal meningitis in Atlanta, Baltimore, and San Antonio, which were identified through population-based active surveillance from November 1994 to April 1996. Pneumococcal isolates from 9% of the cases were resistant to cefotaxime, and isolates from 11% had intermediate susceptibility. Children were more likely to have cephalosporin-nonsusceptible pneumococcal meningitis, but mortality was significantly higher among adults aged 18-64 years. Vancomycin was given upon admission to 29% of patients, and within 48 h of admission to 52%. Nonsusceptibility to cefotaxime was not associated with the following outcomes: increased mortality, prolonged length of hospital or intensive care unit (ICU) stay, requirement of intubation or oxygen, ICU care, discharge to another medical or long-term-care facility, or neurological deficit. Empirical use of vancomycin, current prevalence of drug-resistant S. pneumoniae, and degree of nonsusceptibility to cefotaxime may have influenced these findings.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Distribution</subject><subject>Age groups</subject><subject>Aged</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the nervous system. Bacterial myositis</subject><subject>Biological and medical sciences</subject><subject>Cefotaxime - pharmacology</subject><subject>Cephalosporin Resistance</subject><subject>Cephalosporins - pharmacology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Clinical Articles</subject><subject>Corticosteroids</subject><subject>Female</subject><subject>Health outcomes</subject><subject>Hospital admissions</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infectious diseases</subject><subject>Intensive care units</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Meningitis, Pneumococcal - drug therapy</subject><subject>Meningitis, Pneumococcal - epidemiology</subject><subject>Meningitis, Pneumococcal - microbiology</subject><subject>Meningitis, Pneumococcal - pathology</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Pneumococcal meningitis</subject><subject>Population Surveillance</subject><subject>Risk Factors</subject><subject>Streptococcus pneumoniae</subject><subject>Streptococcus pneumoniae - drug effects</subject><subject>USA, Georgia, Atlanta</subject><subject>USA, Maryland, Baltimore</subject><subject>USA, Texas, San Antonio</subject><subject>Vancomycin - therapeutic use</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkFtrFDEYhoMo9qD-ApEIxbupOUwOc1m27VbYUjyB9CZkst9o6kwyJhmw_95ZZmm9Ea8SeJ-8-b4HoVeUnFKi5XtOuSTyCTqkgqtKioY-ne9E6KrWXB-go5zvCKFUE_EcHVAiaaO4PETdqvfBO9vjm6m4OEDGscPXEHz47ovPeGWnDFvc3uPPJcFYoovOTRmPAaYhBm8B-4DLD8AXye7enoXiWx-Ld_gTZJ-LDQ5eoGed7TO83J_H6OvlxZfVVbW5WX9YnW0qVwtWKqWZYow0gjDRCGaVUp3rFNPOurZ1VDTKcgGdFnorJOfUSSeZALYlnDho-DF6t_SOKf6aIBcz-Oyg722AOGWjiGa1IOK_IFVa85qwR9ClmHOCzozJDzbdG0rMTr1Z1M_gm33j1A6w_QtbXM_AyR6weRbepVmMz4_cvHojdpO9XbA4jf_-6_XC3OUS0wNV15pRtquolni2D78fYpt-Gqm4Eubq263Z3H5cr89VbSj_A1WNrB0</recordid><startdate>200001</startdate><enddate>200001</enddate><creator>Fiore, Anthony E.</creator><creator>Moroney, John F.</creator><creator>Farley, Monica M.</creator><creator>Harrison, Lee H.</creator><creator>Patterson, Jan E.</creator><creator>Jorgensen, James H.</creator><creator>Cetron, Martin</creator><creator>Kolczak, Margarette S.</creator><creator>Breiman, Robert F.</creator><creator>Schuchat, Anne</creator><general>The University of Chicago Press</general><general>University of Chicago Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>200001</creationdate><title>Clinical Outcomes of Meningitis Caused by Streptococcus pneumoniae in the Era of Antibiotic Resistance</title><author>Fiore, Anthony E. ; Moroney, John F. ; Farley, Monica M. ; Harrison, Lee H. ; Patterson, Jan E. ; Jorgensen, James H. ; Cetron, Martin ; Kolczak, Margarette S. ; Breiman, Robert F. ; Schuchat, Anne</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c452t-782722095025952a777fcf728cacbbc1597a35ef858d56331c6c625e2d030ce93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Distribution</topic><topic>Age groups</topic><topic>Aged</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Bacterial diseases</topic><topic>Bacterial diseases of the nervous system. Bacterial myositis</topic><topic>Biological and medical sciences</topic><topic>Cefotaxime - pharmacology</topic><topic>Cephalosporin Resistance</topic><topic>Cephalosporins - pharmacology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Clinical Articles</topic><topic>Corticosteroids</topic><topic>Female</topic><topic>Health outcomes</topic><topic>Hospital admissions</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infectious diseases</topic><topic>Intensive care units</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Meningitis, Pneumococcal - drug therapy</topic><topic>Meningitis, Pneumococcal - epidemiology</topic><topic>Meningitis, Pneumococcal - microbiology</topic><topic>Meningitis, Pneumococcal - pathology</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Pneumococcal meningitis</topic><topic>Population Surveillance</topic><topic>Risk Factors</topic><topic>Streptococcus pneumoniae</topic><topic>Streptococcus pneumoniae - drug effects</topic><topic>USA, Georgia, Atlanta</topic><topic>USA, Maryland, Baltimore</topic><topic>USA, Texas, San Antonio</topic><topic>Vancomycin - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fiore, Anthony E.</creatorcontrib><creatorcontrib>Moroney, John F.</creatorcontrib><creatorcontrib>Farley, Monica M.</creatorcontrib><creatorcontrib>Harrison, Lee H.</creatorcontrib><creatorcontrib>Patterson, Jan E.</creatorcontrib><creatorcontrib>Jorgensen, James H.</creatorcontrib><creatorcontrib>Cetron, Martin</creatorcontrib><creatorcontrib>Kolczak, Margarette S.</creatorcontrib><creatorcontrib>Breiman, Robert F.</creatorcontrib><creatorcontrib>Schuchat, Anne</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fiore, Anthony E.</au><au>Moroney, John F.</au><au>Farley, Monica M.</au><au>Harrison, Lee H.</au><au>Patterson, Jan E.</au><au>Jorgensen, James H.</au><au>Cetron, Martin</au><au>Kolczak, Margarette S.</au><au>Breiman, Robert F.</au><au>Schuchat, Anne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Outcomes of Meningitis Caused by Streptococcus pneumoniae in the Era of Antibiotic Resistance</atitle><jtitle>Clinical infectious diseases</jtitle><stitle>Clinical Infectious Diseases</stitle><addtitle>Clinical Infectious Diseases</addtitle><date>2000-01</date><risdate>2000</risdate><volume>30</volume><issue>1</issue><spage>71</spage><epage>77</epage><pages>71-77</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>Limited data are available on clinical outcomes of meningitis due to cefotaxime-nonsusceptible Streptococcus pneumoniae. We analyzed data from 109 cases of pneumococcal meningitis in Atlanta, Baltimore, and San Antonio, which were identified through population-based active surveillance from November 1994 to April 1996. Pneumococcal isolates from 9% of the cases were resistant to cefotaxime, and isolates from 11% had intermediate susceptibility. Children were more likely to have cephalosporin-nonsusceptible pneumococcal meningitis, but mortality was significantly higher among adults aged 18-64 years. Vancomycin was given upon admission to 29% of patients, and within 48 h of admission to 52%. Nonsusceptibility to cefotaxime was not associated with the following outcomes: increased mortality, prolonged length of hospital or intensive care unit (ICU) stay, requirement of intubation or oxygen, ICU care, discharge to another medical or long-term-care facility, or neurological deficit. Empirical use of vancomycin, current prevalence of drug-resistant S. pneumoniae, and degree of nonsusceptibility to cefotaxime may have influenced these findings.</abstract><cop>Chicago, IL</cop><pub>The University of Chicago Press</pub><pmid>10619736</pmid><doi>10.1086/313606</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Age Distribution Age groups Aged Anti-Bacterial Agents - therapeutic use Antibiotics Bacterial diseases Bacterial diseases of the nervous system. Bacterial myositis Biological and medical sciences Cefotaxime - pharmacology Cephalosporin Resistance Cephalosporins - pharmacology Child Child, Preschool Children Clinical Articles Corticosteroids Female Health outcomes Hospital admissions Human bacterial diseases Humans Incidence Infant Infant, Newborn Infectious diseases Intensive care units Male Medical sciences Meningitis, Pneumococcal - drug therapy Meningitis, Pneumococcal - epidemiology Meningitis, Pneumococcal - microbiology Meningitis, Pneumococcal - pathology Middle Aged Mortality Pneumococcal meningitis Population Surveillance Risk Factors Streptococcus pneumoniae Streptococcus pneumoniae - drug effects USA, Georgia, Atlanta USA, Maryland, Baltimore USA, Texas, San Antonio Vancomycin - therapeutic use |
| title | Clinical Outcomes of Meningitis Caused by Streptococcus pneumoniae in the Era of Antibiotic Resistance |
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