Hizel Kenan, Güzel Ozlem, Altunçekiç Arzu, Gür Deniz, Arman Dilek
Gazi Universitesi Tip Fakültesi, Klinik Bakteriyoloji ve Enfeksiyon Hastaliklari Anabilim Dali, Ankara.
Mikrobiyol Bul. 2003 Jan;37(1):65-9.
Streptococcus pneumoniae is one of the leading causes of acute bacterial meningitis and the emergence of antibiotic resistant pneumococci is an increasing problem worldwide. In this report, a 22-years-old woman was presented with pneumococcal meningitis occurring twice in a 5 months period. After the first meningitis attack, the patient had been vaccinated by 23-valent polysaccharide vaccine but the illness has relapsed. Although S. pneumoniae which was isolated from the patient has been found intermediate resistant to penicillin and susceptible to ceftriaxone by E-test, the patient could be treated only with meropenem. The case has been presented and discussed for ceftriaxone failure in spite of in-vitro susceptibility. On the other hand, this case indicated that vaccination might fail to prevent recurrence.
肺炎链球菌是急性细菌性脑膜炎的主要病因之一，而抗生素耐药肺炎球菌的出现是全球范围内日益严重的问题。在本报告中，一名22岁女性在5个月内两次出现肺炎球菌性脑膜炎。首次脑膜炎发作后，患者接种了23价多糖疫苗，但疾病仍复发。尽管通过E试验发现从患者分离出的肺炎链球菌对青霉素呈中度耐药且对头孢曲松敏感，但该患者仅用美罗培南治疗。尽管体外药敏试验显示敏感，但仍出现头孢曲松治疗失败的情况，本文对此病例进行了介绍和讨论。另一方面，该病例表明疫苗接种可能无法预防复发。
