Les méningites à  Streptococcus pneumoniae au CHU d'Amiens de 1990 à  2005. Aspects bactériologiques des souches isolées

Streptococcus pneumoniae is actually the first most likely organism to cause meningitis in children 2 months to 2 years old and in adults older than 65 years. From January 1990 to December 2005, 72 cases of S. pneumoniae-positive cerebrospinal fluid culture were indexed in our hospital. Among the 72 cases, 25 came from children, and 60% of these came from children under two years of age and 47 came from adults whose the mean age was 55 years. The first penicillin-resistant S. pneumoniae (PNSP) meningitis was identified in 1993. The susceptibility to penicillin of pneumococcal isolates causing meningitis varied according to time; until 1995, 25% of the strains were PNSP, then from 1996 to 2005, 50% of strains were PNSP. The overall prevalence of non-susceptible was 34.7% (25/72). Among the 25 PNSP, 21 were intermediate to penicillin G and four of them were resistant. Among children, seven PNSP meningitis were indexed and one of them was resistant. The antimicrobial MICs of amoxicillin and cefotaxim varied from 0.064 to 1 mg/l and from 0.016 to 0.5 mg/l respectively. Among adults, 18 PNSP meningitis were indexed. Three strains were penicillin-resistant. The antimicrobial MICs of amoxicillin varied from 0.064 to 2 mg/l. Nine strains of 18 PNSP had cefotaxim MIC ≥ 0.5 mg/l and, four of them had MIC 1 mg/l. None amoxicillin and cefotaxim-resistant strain was isolated. Serotyping of all strains was performed in the Reference Center. Serotypes 6B, 9V and 19 were the most frequent in child and serotypes 6B, 23F, 19, 9, 4 were the most frequent in adult. So, all serotypes were represented.