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. 1996 Aug;117(1):95–102. doi: 10.1017/s0950268800001175

Pneumococcal meningitis in the North East Thames Region UK: epidemiology and molecular analysis of isolates.

G Urwin 1, M F Yuan 1, L M Hall 1, K Brown 1, A Efstratiou 1, R A Feldman 1
PMCID: PMC2271685  PMID: 8760955

Abstract

One hundred and fourteen cases of pneumococcal meningitis were identified by prospective laboratory based surveillance during 1990-3 in the North East Thames Region. Higher rates of disease were seen in Asians (2.1/100000) than Caucasians (0.8/100000) (P = 0.002). The incidence of meningitis was higher in children than adults, while mortality rates were highest in adults over the age of 60 (48%). In 72 cases, both blood and CSF were culture positive. Serotyping of 65 isolates collected identified 22 serotypes (and one non-typable) causing disease, the most common being serotype 6 (13 cases) and serotype 14 (11 cases). Overall, 90% of serotype antigens identified were represented in the 23 valent vaccine. Ribotyping of 62 isolates identified 35 different patterns, of which 26 were single types. Different ribotypes were found among isolates of the same serotypes, with the exception of serotype 14, where 9 of 11 isolates had the same ribotype pattern. Four percent of isolates had reduced susceptibility to penicillin, but no high level penicillin resistance was found.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Asensi F., Otero M. C., Pérez-Tamarit D., Rodríguez-Escribano I., Cabedo J. L., Gresa S., Cantón E. Risk/benefit in the treatment of children with imipenem-cilastatin for meningitis caused by penicillin-resistant pneumococcus. J Chemother. 1993 Apr;5(2):133–134. doi: 10.1080/1120009x.1993.11739221. [DOI] [PubMed] [Google Scholar]
  2. Breiman R. F., Butler J. C., Tenover F. C., Elliott J. A., Facklam R. R. Emergence of drug-resistant pneumococcal infections in the United States. JAMA. 1994 Jun 15;271(23):1831–1835. [PubMed] [Google Scholar]
  3. Fenoll A., Martín Bourgon C., Muñz R., Vicioso D., Casal J. Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae isolates causing systemic infections in Spain, 1979-1989. Rev Infect Dis. 1991 Jan-Feb;13(1):56–60. doi: 10.1093/clinids/13.1.56. [DOI] [PubMed] [Google Scholar]
  4. Friedland I. R., Shelton S., Paris M., Rinderknecht S., Ehrett S., Krisher K., McCracken G. H., Jr Dilemmas in diagnosis and management of cephalosporin-resistant Streptococcus pneumoniae meningitis. Pediatr Infect Dis J. 1993 Mar;12(3):196–200. doi: 10.1097/00006454-199303000-00004. [DOI] [PubMed] [Google Scholar]
  5. Hall L. M., Duke B., Guiney M., Williams R. Typing of Enterococcus species by DNA restriction fragment analysis. J Clin Microbiol. 1992 Apr;30(4):915–919. doi: 10.1128/jcm.30.4.915-919.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hermans P. W., Sluijter M., Hoogenboezem T., Heersma H., van Belkum A., de Groot R. Comparative study of five different DNA fingerprint techniques for molecular typing of Streptococcus pneumoniae strains. J Clin Microbiol. 1995 Jun;33(6):1606–1612. doi: 10.1128/jcm.33.6.1606-1612.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Jorgenson J. H., Howell A. W., Maher L. A., Facklam R. R. Serotypes of respiratory isolates of Streptococcus pneumoniae compared with the capsular types included in the current pneumococcal vaccine. J Infect Dis. 1991 Mar;163(3):644–646. doi: 10.1093/infdis/163.3.644. [DOI] [PubMed] [Google Scholar]
  8. Kuikka A., Syrjänen J., Renkonen O. V., Valtonen V. V. Pneumococcal bacteraemia during a recent decade. J Infect. 1992 Mar;24(2):157–168. doi: 10.1016/0163-4453(92)92850-i. [DOI] [PubMed] [Google Scholar]
  9. Lafong A. C., Crothers E., Bamford K. B., Rooney P. J. Distribution of serotypes and antibiotic resistance among pneumococci in Northern Ireland. J Infect. 1988 May;16(3):235–242. doi: 10.1016/s0163-4453(88)97556-1. [DOI] [PubMed] [Google Scholar]
  10. Lefevre J. C., Faucon G., Sicard A. M., Gasc A. M. DNA fingerprinting of Streptococcus pneumoniae strains by pulsed-field gel electrophoresis. J Clin Microbiol. 1993 Oct;31(10):2724–2728. doi: 10.1128/jcm.31.10.2724-2728.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Manresa F., Dorca J., Liñares J., Martin R., Pallarés R. Empirical treatment of pneumococcal pneumonia in Spain. Lancet. 1989 Jun 10;1(8650):1338–1339. doi: 10.1016/s0140-6736(89)92743-8. [DOI] [PubMed] [Google Scholar]
  12. Marton A., Gulyas M., Munoz R., Tomasz A. Extremely high incidence of antibiotic resistance in clinical isolates of Streptococcus pneumoniae in Hungary. J Infect Dis. 1991 Mar;163(3):542–548. doi: 10.1093/infdis/163.3.542. [DOI] [PubMed] [Google Scholar]
  13. Muñoz R., Coffey T. J., Daniels M., Dowson C. G., Laible G., Casal J., Hakenbeck R., Jacobs M., Musser J. M., Spratt B. G. Intercontinental spread of a multiresistant clone of serotype 23F Streptococcus pneumoniae. J Infect Dis. 1991 Aug;164(2):302–306. doi: 10.1093/infdis/164.2.302. [DOI] [PubMed] [Google Scholar]
  14. Parkinson A. J., Davidson M., Fitzgerald M. A., Bulkow L. R., Parks D. J. Serotype distribution and antimicrobial resistance patterns of invasive isolates of Streptococcus pneumoniae: Alaska 1986-1990. J Infect Dis. 1994 Aug;170(2):461–464. doi: 10.1093/infdis/170.2.461. [DOI] [PubMed] [Google Scholar]
  15. Robbins J. B., Austrian R., Lee C. J., Rastogi S. C., Schiffman G., Henrichsen J., Mäkelä P. H., Broome C. V., Facklam R. R., Tiesjema R. H. Considerations for formulating the second-generation pneumococcal capsular polysaccharide vaccine with emphasis on the cross-reactive types within groups. J Infect Dis. 1983 Dec;148(6):1136–1159. doi: 10.1093/infdis/148.6.1136. [DOI] [PubMed] [Google Scholar]
  16. Sessegolo J. F., Levin A. S., Levy C. E., Asensi M., Facklam R. R., Teixeira L. M. Distribution of serotypes and antimicrobial resistance of Streptococcus pneumoniae strains isolated in Brazil from 1988 to 1992. J Clin Microbiol. 1994 Apr;32(4):906–911. doi: 10.1128/jcm.32.4.906-911.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Shapiro E. D., Berg A. T., Austrian R., Schroeder D., Parcells V., Margolis A., Adair R. K., Clemens J. D. The protective efficacy of polyvalent pneumococcal polysaccharide vaccine. N Engl J Med. 1991 Nov 21;325(21):1453–1460. doi: 10.1056/NEJM199111213252101. [DOI] [PubMed] [Google Scholar]
  18. Shibl A. M., Hussein S. S. Surveillance of Streptococcus pneumoniae serotypes in Riyadh and their susceptibility to penicillin and other commonly prescribed antibiotics. J Antimicrob Chemother. 1992 Feb;29(2):149–157. doi: 10.1093/jac/29.2.149. [DOI] [PubMed] [Google Scholar]
  19. Simberkoff M. S., Lukaszewski M., Cross A., Al-Ibrahim M., Baltch A. L., Smith R. P., Geiseler P. J., Nadler J., Richmond A. S. Antibiotic-resistant isolates of Streptococcus pneumoniae from clinical specimens: a cluster of serotype 19A organisms in Brooklyn, New York. J Infect Dis. 1986 Jan;153(1):78–82. doi: 10.1093/infdis/153.1.78. [DOI] [PubMed] [Google Scholar]
  20. Spika J. S., Facklam R. R., Plikaytis B. D., Oxtoby M. J. Antimicrobial resistance of Streptococcus pneumoniae in the United States, 1979-1987. The Pneumococcal Surveillance Working Group. J Infect Dis. 1991 Jun;163(6):1273–1278. doi: 10.1093/infdis/163.6.1273. [DOI] [PubMed] [Google Scholar]
  21. Steven N., Wright P. Pneumococcal immunisation and the healthy elderly. Lancet. 1992 Oct 24;340(8826):1036–1037. doi: 10.1016/0140-6736(92)93048-r. [DOI] [PubMed] [Google Scholar]
  22. Urwin G., Yuan M. F., Feldman R. A. Prospective study of bacterial meningitis in North East Thames region, 1991-3, during introduction of Haemophilus influenzae vaccine. BMJ. 1994 Nov 26;309(6966):1412–1414. doi: 10.1136/bmj.309.6966.1412. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Verhaegen J., Glupczynski Y., Verbist L., Blogie M., Vandeven J., Yourassowsky E., Vandepitte J. Capsular types and antibiotic sensitivity of pneumococci isolated from patients with serious infections in Belgium 1980 to 1988. Eur J Clin Microbiol Infect Dis. 1990 Jun;9(6):390–395. doi: 10.1007/BF01979467. [DOI] [PubMed] [Google Scholar]
  24. Versalovic J., Kapur V., Mason E. O., Jr, Shah U., Koeuth T., Lupski J. R., Musser J. M. Penicillin-resistant Streptococcus pneumoniae strains recovered in Houston: identification and molecular characterization of multiple clones. J Infect Dis. 1993 Apr;167(4):850–856. doi: 10.1093/infdis/167.4.850. [DOI] [PubMed] [Google Scholar]
  25. Viering T. P., Fine D. P. Genetic analysis of Streptococcus pneumoniae serotypes with the use of DNA fingerprinting. J Infect Dis. 1989 Jul;160(1):76–82. doi: 10.1093/infdis/160.1.76. [DOI] [PubMed] [Google Scholar]
  26. Waltman W. D., 2nd, Talkington D. F., Lipinski A. E., Crain M. J., Dixon J. M., Briles D. E. Evidence for a clonal origin of relative penicillin resistance among type 9L pneumococci in northwestern Canada. J Infect Dis. 1992 Apr;165(4):671–675. doi: 10.1093/infdis/165.4.671. [DOI] [PubMed] [Google Scholar]
  27. Wenger J. D., Hightower A. W., Facklam R. R., Gaventa S., Broome C. V. Bacterial meningitis in the United States, 1986: report of a multistate surveillance study. The Bacterial Meningitis Study Group. J Infect Dis. 1990 Dec;162(6):1316–1323. doi: 10.1093/infdis/162.6.1316. [DOI] [PubMed] [Google Scholar]

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