Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-25T19:25:54.971Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  15 May 2009

G. Urwin ,
M. F. Yuan ,
L. M. C. Hall ,
K. Brown ,
A. Efstratiou  and
R. A. Feldman
G. Urwin*
Affiliation:
Department of Medical Microbiology, The London Hospital Medical College, Turner Street, London EI 2AD
M. F. Yuan
Affiliation:
Department of Medical Microbiology, The London Hospital Medical College, Turner Street, London EI 2AD
L. M. C. Hall
Affiliation:
Department of Medical Microbiology, The London Hospital Medical College, Turner Street, London EI 2AD
K. Brown
Affiliation:
Central Public Health Laboratory, Respiratory and Systemic Infection Laboratory, 61 Colindale Avenue, London NW9 5HT
A. Efstratiou
Affiliation:
Central Public Health Laboratory, Respiratory and Systemic Infection Laboratory, 61 Colindale Avenue, London NW9 5HT
R. A. Feldman
Affiliation:
Department of Epidemiology and Medical Statistics, The London Hospital Medical College, Mile End Road, London E1
*
* Current address: Department of Microbiology, Greenwich District Hospital, Vanbrugh Hill, London SE10, UK
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

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 (2·1/100 000) than Caucasians (0·8/100 000) (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.

Type
Research Article
Information
Epidemiology & Infection , Volume 117 , Issue 1 , August 1996 , pp. 95 - 102
Copyright
Copyright © Cambridge University Press 1996

References

1.Urwin, G, Yuan, MF, Feldman, RAF.The epidemiology of bacterial meningitis in the North East Thames region: a three year prospective study during the introduction of vaccination against Haemophilus influenzae type b. B M J 1994; 209: 1412–4.CrossRefGoogle Scholar
2.Wenger, JD, Hightower, AW, Facklam, RR, Gaventa, S, Broome, CV, the Bacterial Meningitis Study Group. Bacterial Meningitis in the United States, 1986: Report of a multistate surveillance study. J Infect Dis 1990; 162: 1316–23.CrossRefGoogle Scholar
3.Robbins, JB, Austrian, R, Lee, CJ, et al. Considerations for formulating the second-generation pneumococcal capsular polysaccharide vaccine with emphasis on the cross-reactive types within groups. J Infect Dis 1983; 148: 1136–59.CrossRefGoogle ScholarPubMed
4.Jorgensen, JH, Howell, AW, Maher, LA, Facklam, R.Serotypes of respiratory isolates of Streptococcus pneumoniae compared with the capsular types included in the current pneumococcal vaccine. J Infect Dis 1991; 163: 644–6.CrossRefGoogle Scholar
5.Lafong, AC, Crothers, E, Bamford, KB, Rooney, PJ.Distribution of serotypes and antibiotic resistance among pneumococci in Norther Ireland. J Infect 1988; 16: 235–42.CrossRefGoogle Scholar
6.Verhaegen, J, Gulpczynski, Y, Verbist, L, et al. Capsular types and antibiotic sensitivity of pneumococci isolated from patients with serious pneumococcal infections in Belgium 1980–1988. J Clin Microbiol Infect Dis 1990; 9: 390–5.CrossRefGoogle Scholar
7.Immunisation against infectious disease. London: HMSO, 1992: 100–3.Google Scholar
8.Leads from the MMWR. Recommendations of the immunization practices advisory committe on pneumococcal polysaccharide vaccine. JAMA 1989; 261: 1265–7.Google Scholar
9.Sharpio, ED, Berg, AT, Austrian, R, et al. The protective efficacy of polyvalent pneumococcal polysaccharide vaccine. N Engl J Med 1991; 325: 1453–9.Google Scholar
10.Muñoz, R, Coffey, TJ, Daniels, M, et al. Intercontinental spread of a multiresistant clone of serotype 23F Streptococcus pneumoniae. J Infect Dis 1991; 164: 302–6.CrossRefGoogle ScholarPubMed
11.Versalovic, J, Kapur, V, Mason, EO Jr, et al. Penicillin resistant Streptococcus pneumoniae strains recovered in Houston: identification and molecular characterization of multiple clones. J Infect Dis 1993; 167: 850–6.CrossRefGoogle ScholarPubMed
12.Waltman, WE III, Talkington, D, Lipinski, AE, Crain, MJ, Dixon, JMS, Briles, DE.Evidence for a clonal origin of relative penicillin resistance among type 9L pneumococci from Northerwestern Canada. J Infect Dis 1992; 165: 671–5.CrossRefGoogle Scholar
13.Simberkoff, MS, Lukaszewski, M, Cross, A, et al. Antibiotic resistance isolates of Streptococcus pneumoniae from clinical specimens: a cluster of serotype 19A organisms in Brooklyn, New York. J Infect Dis 1986; 153: 78–82.CrossRefGoogle ScholarPubMed
14.Lund, E, Henrichsen, J.Laboratory diagnosis serology and epidemiology of Streptococcus pneumoniae. Methods in microbiology, vol. 12. London: Academic Press, 1978.Google Scholar
15.Pitcher, DG, Saunders, NA, Owen, RJ.Rapid extraction of bacterial genomic DNA with guanidium thiocyanate. Lett Appl Microbiol 1989; 8: 151–6.CrossRefGoogle Scholar
16.Hall, LMC, Duke, B, Guiney, M, Williams, R.Typing of Enterococcus species by DNA restriction fragment analysis. J Clin Microbiol 1992; 30: 915–9.CrossRefGoogle ScholarPubMed
17.Sanbrook, J, Fritsch, EF, Maniatis, T.Molecular cloning: a laboratory manual. Cold Spring Harbour. N. Y.: Cold Spring Harbor Laboratory Press, 1989.Google Scholar
18.Steven, N, Wright, P.Pneumococcal immunisation and the healthy elderly. Lancet 1992; 340: 1036–7.CrossRefGoogle ScholarPubMed
19.Kuikka, A, Syrjänen, J, Renkonen, O-V, Valtonen, VV.Pneumococcal bacteraemia during a recent decade. J Infect 1992; 24: 157–68.CrossRefGoogle ScholarPubMed
20.Sessegolo, JF, Levin, AS, Levy, CE, Asensi, M, Facklam, RR, Teixeira, LM.Distribution of serotypes and antimicrobial resistance of Streptococcus pneumoniae strains isolated in Brazil from 1988 to 1992. J Clin Microbiol 1994; 32: 906–11.CrossRefGoogle ScholarPubMed
21.Parkinson, AJ, Davidson, M, Fitzgerald, MA, Bulkow, LR, Parks, DJ.Serotype distribution and antimicrobial resistance patterns of invasive isolates of Streptococcus pneumoniae: Alaska 1986–1990. J Infect Dis 1994; 170: 461–4.CrossRefGoogle ScholarPubMed
22.Shibl, AM, Hussein, SS.Surveillance of Streptococcus pneumoniae serotypes in Riyadh and their susceptibility to penicillin and other common prescribed antibiotics. J Antimicrob Chemother 1992; 29: 149–57.CrossRefGoogle Scholar
23.Fenoll, A, Martin Bourgon, C, Munoz, 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; 13: 56–60.CrossRefGoogle ScholarPubMed
24.Viering, TP, Fine, DP.Genetic analysis of Streptococcus pneumoniae serotypes with the of DNA fingerprinting. J infect Dis 1989; 160: 76–82.CrossRefGoogle ScholarPubMed
25.Lefevre, JC, Faucon, G, Sicard, AM, Gasc, AM.DNA fingerprinting of Streptococcus pneumoniae strains by pulsed field gel electrophoresis. J Clin Microbiol 1993; 31: 2724–8.CrossRefGoogle ScholarPubMed
26.Hermans, PWM, Sluijter, M, Hoogenboezem, T, Heersma, H, Van Belkum, A, De Groot, R.Comparative study of five different DNA fingerprint techniques for molecular typing Streptococcus pneumoniae strains. J Clin Microbiol 1995; 33: 1606–12.CrossRefGoogle ScholarPubMed
27.George, RC, Ball, LC, Cooper, PG.Antibiotic resistant pneumococci in the United Kingdom. C D R Rev 1992; 4: R37–43.Google Scholar
28.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; 163: 542–8.CrossRefGoogle ScholarPubMed
29.Manresa, F, Dorca, J, Linares, J, Martin, R, Pallares, R.Empirical treatment of pneumococcal pneumonia in Spain. Lancet 1989; 1338–9.CrossRefGoogle ScholarPubMed
30.Spika, JS, Facklam, RR, Plikaytis, BD, Oxtoby, MJ.Pneumococcal Surveillance Working Group. Antimicrobial resistance of Streptococcus pneumoniae in the United States 1979–87. J Infect Dis 1991; 163: 1273–8.CrossRefGoogle Scholar
31.Breiman, RF, Butler, JC, Tenover, FC, Elliott, JA, Facklam, RR.Emergence of Drug resistant pneumococcal infections in the United States. JAMA 1994; 271: 1831–5.CrossRefGoogle ScholarPubMed
32.Asensi, F, Pérez-Tamarit, D, Otero, MC, et al. Imipenemcilastatin therapy in a child with meningitis caused by penicillin resistant pneumococcus. J Chemother 1993; 5: 133–4.CrossRefGoogle Scholar
33.Friedland, IR, Shelton, S, Paris, M, et al. Dilemmas in diagnosis and management of cephalosporin resistant Streptococcus pneumoniae meningitis. Pediatr Infect Dis J 1993; 12: 196–200.CrossRefGoogle ScholarPubMed