First Report of a Case of Pneumococcal Meningitis Which Did Not Respond to the Ceftriaxone Therapy despite the Isolated Organism Being Sensitive to This Antibiotic In Vitro

Abstract

A 60-year-old man presented with pneumococcal meningitis which did not respond to the ceftriaxone therapy, in spite of in-vitro susceptibility (minimal inhibitory concentration of 0.016 μg/dLit) of the isolated organism to this antibacterial agent, although ceftriaxone is still the drug of choice for such pneumococcal meningitis. Review of published articles revealed no report of clinical resistance in organisms which were susceptible to the same antimicrobial agent in vitro. This alarming emergence of isolates with in vivo resistance should be considered and even could lead to a shift in the empirical antibiotic therapy for pneumococcal infections.

A case of pneumococcal meningitis due to fall from height

“…We encountered a case of bacterial meningitis with S. pneumonia. Although data on bacterial meningitis particularly on S. pneumoniae in Iran have been previously reported (5,6), our study shows precisely in a teaching hospital in Karaj, presenting with better clarity, and the susceptibility pattern of S. pneumoniae to ceftriaxone, ciprofloxacin, vancomycin, and imipenem for the first time. Identification and antibacterial resistance of the causative agent are key factors of effective antibiotic treatment.…”

Prevalence of Ceftriaxon-Sensitive Pneumococci Infection and Use of E- Test for Patients Admitted to Ghaem and Imam Reza Hospitals During a Two-Year Period

“…Despite low level of resistance in previous study, in a retrospective study in a university hospital in Taiwan (2000 -2007), 18.4% of non-meningeal and 34.9% of meningeal isolates (a total number of 3729 isolates) were not susceptible to Ceftriaxone (23). Moreover, in a study conducted in Riyadh, Kingdom of Saudi Arabia, from February 2000 and November 2001, including 78 isolates of S. Pneumonia from different samples (blood, cerebrospinal fluid, bone, and peritoneal fluid) only 1.28% of isolates were resistant to Ceftriaxone (24) although authors suggested Ceftriaxone for treating invasive pneumococcal infections other than the central nervous system infections (25). A large study included 1,000 clinical isolates of S pneumonia, collected by U.S. laboratories in 2001-2002 showed that nearly 2% of isolates were resistant to Ceftriaxone (26).…”