Pneumococcal meningitis: clinical and epidemiological features, and circulating pathogens’ serotype distribution in Krasnoyarsk territory

Abstract

The purpose of the research: To investigate clinical and epidemiological features, clinical course and outcomes of pneumococcal meningoencephalitis in children, Streptococcus pneumoniae serotype distribution and their compliance with antigenic composition of existing pneumococcal vaccines, as well as antimicrobial resistance of the pathogen.Research tasks: 1. To characterize the clinical features of pneumococcal meningitis; 2. To study the serotypes and antimicrobial resistance of S. pneumoniae strains isolated from patients with pneumococcal meningitis; 3. To detect the genotypes (ST-types) of S. pneumoniae strains.Materials and Methods: There were 17 patients aged 2-15 years with pneumococcal meningitis under the supervision. DNA isolation of S. pneumoniae was done by «AmpliSens DNA-sorb B» kits (InterLabServise, Russia). Multiplex PCR was used for serotype deduction. S. pneumoniae antimicrobial resistance was investigated by Etest (bioMerieux, France). Statistical analysis was conducted by Microsoft Excel, and included the determination of percentages, averages, and mean deviations.Results: Pneumococci can cause not only meningeal lesions itself, but brain substance damage; it results to secondary severe meningoencephalitis with complicated course (cerebral edema, cerebral coma, and ventriculitis). S. pneumoniae serotypes identified (14, 19F, 3, 7F, 6AB) are common, most often causing meningitis in children and adults. All these serotypes are vaccine-preventable. More than half of isolates revealed penicillin-resistance.Conclusion: Due to complete accordance of S. pneumoniae serotypes detected to those included in widely used 13-valent pneumococcal conjugated vaccine (PCV13), the vaccination should be considered as effective preventive measure. The features of pneumococcal sensitivity to antimicrobials must be considered when prescribing antibiotics.

Keywords

• pneumococcal infection
• pneumococcal meningitis
• clinical course
• outcomes
• antibiotics
• children