ABSTRACT
We present a case of meningitis caused by Hemophilus influenzae type'b in an immunocompetent 41-year-old Saudi lady. The patient was successfully treated with Ceftriaxone for 10 days. A review of Hemophilus influenzae meningitis in adults and the impact of conjugated vaccine on the epidemiology of the disease are given
Subject(s)
Humans , Female , Meningitis, Haemophilus/diagnosis , Meningitis, Haemophilus/drug therapy , Meningitis, Haemophilus/cerebrospinal fluid , Anti-Infective Agents , Ceftriaxone , ImmunocompetenceABSTRACT
From 1989 to 1995, a total of 391 Haemophilus influenzae isolates were recovered from the cerebrospinal fluid (CSF) of hospitalized patients in São Paulo, Brazil. The majority of strains were isolated from infants aged less than 5 years. Strains belonging to biotype I (64.7 per cent), biotype II (34.5 per cent) and biotype IV (0.76 per cent) were detected. Ninety-nine percent of these strains were serotype b. Minimal inhibitory concentration (MIC) was determined for ampicillin, chloramphenicol and ceftriaxone. The ß-lactamase assay was performed for all strains. The rate of ß-lactamase producer strains ranged from 10 to 21.4 per cent during a period of 7 years, with an overall rate of 13.8 per cent. Of the 391 strains analyzed, none was ß-lactamase negative ampicillin resistant (BLNAR). A total of 9.7 per cent of strains showed resistance to both ampicillin and chloramphenicol; however, 4 per cent of them were resistant to ampicillin only and 2 per cent to chloramphenicol. All strains were susceptible to ceftriaxone and the MIC90 was 0.007 µg/ml, suggesting that ceftriaxone could be an option for the treatment of bacterial meningitis in pediatric patients who have not been screened for drug sensitivity.
Subject(s)
Humans , Child , Anti-Bacterial Agents/pharmacology , Haemophilus influenzae/drug effects , Meningitis, Haemophilus/drug therapy , Ampicillin/pharmacology , Ampicillin/therapeutic use , Anti-Bacterial Agents/therapeutic use , beta-Lactamases/biosynthesis , Brazil , Ceftriaxone/pharmacology , Ceftriaxone/therapeutic use , Chloramphenicol/pharmacology , Chloramphenicol/therapeutic use , Drug Resistance, Microbial , Haemophilus influenzae/isolation & purification , Haemophilus influenzae/metabolism , Microbial Sensitivity TestsABSTRACT
The Moroccan Society of Infectious Pathology, in collaboration with the Direction of Epidemiology and Disease Prevention of the Public Health Ministry, organized its second conference on consensus over anti-infectious therapeutic: between the 30th of may and the 2nd of June 1996. This second conference of consensus held in Morocco, treats a subject of common medical practice in infectious Pathology: Treatment of community Purulent Meningitis [Excluding neo-natal meningitis] The Organization and the holding of this conference were inspired from the Methodology advocated by the National Agency for the Development of the French medical evaluation. The conclusion and the recommendations given in this document were written independently by the conference jury
Subject(s)
Humans , Meningitis, Haemophilus/drug therapy , Meningitis, Meningococcal/drug therapy , Meningitis, Pneumococcal/drug therapy , Community-Acquired Infections/therapyABSTRACT
To observe the causative microorganisms responsible for Bacterial Pyogenic Meningitis. Prospective and Retrospective study of 232 patients suffering from Bacterial Pyogenic Meningitis. Children and Medical wards of Peoples Medical College Hospital Nawabshah and Civil Hospital, Sanghar. Two hundred thirty two cases of Bacterial Pyogenic Meningitis with different age groups from neonates to old subjects. Main outcome measures: Clinical features of patient-Biochemical examination of C.S.F. and Culture and sensitivity test. The organisms isolated were in order of frequency, N. meningitidis 51.7%. Strept, pneumonia 43.1%, H. influenzae 4.3% Strept. agalactiae 0.43% and that 70-90% isolates were sensitive to Penicillin G, Ampicillin, Chloramphenical and Co-trimoxazole [Septran]. However 90-100% of these isolates were sensitive to 3rd generation antibiotics. In Bacterial Pyogenic Meningitis most common microorganisms are Strept, pneumonia, N. meningitidis and H. influenzae
Subject(s)
Humans , Male , Female , Meningitis/drug therapy , Drug Resistance, Microbial , Meningitis, Haemophilus/drug therapy , Meningitis, Meningococcal/drug therapy , Meningitis, Pneumococcal/drug therapy , Meningitis, Bacterial/etiology , Neisseria meningitidis/isolation & purificationSubject(s)
Humans , Male , Female , Pregnancy , Infant , Child, Preschool , Child , Adult , Meningitis, Bacterial/drug therapy , Meningitis, Haemophilus/drug therapy , Risk Groups , Meningitis, Bacterial/prevention & control , Meningitis, Haemophilus/prevention & control , Meningitis, Meningococcal/prevention & control , Meningitis, Meningococcal/drug therapy , Meningitis, Pneumococcal/prevention & control , Meningitis, Pneumococcal/drug therapy , Influenza VaccinesABSTRACT
Objetivo: Investigar los "aspectos epidemiológicos" de la patología invasiva Hib (PI Hib) con especial referencia a la meningitis, en niños menores de 5 años. Categorizar el problema dentro de la salud pública en Tucumán. Material y métodos: El estudio se llevó a cabo desde enero de 1985 a diciembre de 1992 en el Hospital del Niño Jesús. Se incluyó a todo paciente con sospecha clínica de PI Hib y confirmada por cultivo o serología obtenida de materiales representativos. Resultados: Se registraron 264 casos de PI Hib: 218 (82,5 por ciento) meningitis y 46 (17,5 por ciento) formas extrameníngeas. El 89 por ciento de las meningitis tuvieron foco único. Las formas extrameníngeas se distribuyeron entre bacteriemias, supuración pleuro-pulmonar, neumonías, celulitis, artritis y otras. La meningitis Hib (M Hib) es endémica en Tucumán, con un aumento en los meses de invierno. El Hib representa el 70 por ciento de las meningitis extrahospitalarias bacterianas. La incidencia anual promedio, en niños menores de 5 años, de la PI Hib fue 20,4/100.000 y de M Hib 16,7/100.000, en menores de 1 año la incidencia de M Hib fue 63/100.000; el 77,5 por ciento de las meningitis suceden a esta edad. La tasa de letalidad: 20,1 por ciento. La resistencia a ampicilina osciló entre 0-17,4 por ciento y la de ampicilina-cloranfenicol entre 2,7-8,7 por ciento. Conclusiones: Al cabo de ocho años de estudio la M Hib mostró en Tucumán un sostenido aumento; es la primera causa de mortalidad dentro de las enfermedades prevenibles por vacunas en niños menores de 2 años y la octava causa de mortalidad infantil
Subject(s)
Humans , Male , Infant, Newborn , Infant , Child, Preschool , Argentina , Haemophilus Infections/epidemiology , Meningitis, Bacterial/epidemiology , Meningitis, Haemophilus/epidemiology , Drug Resistance, Microbial , Haemophilus Infections/mortality , Meningitis, Bacterial/diagnosis , Meningitis, Bacterial/etiology , Meningitis, Haemophilus/drug therapy , Meningitis, Haemophilus/prevention & control , Retrospective StudiesABSTRACT
Foi realizado um ensaio clínico controlado, triplo-cego, cujo delineamento com amostra randomizada incluiu 144 pacientes internados no Centro Geral de Pediatria da Fundaçäo Hospitalar do Estado de Minas Gerais, em Belo Horizonte, de maio de 1992 a setembro de 1993. O objetivo desta investigaçäo foi determinar se a utilizaçäo da dexametasona como terapêutica auxiliar, em fase inicial do tratamento da infecçäo meníngea causada pelo Haemophilus influenzae, Neisseria meningiditis e Streptococcus pneumoniae, altera a evoluçäo daquela patologia. Foram incluídos nesta pesquisa todos os pacientes de dois meses a 14 anos de idade portadores de meningite bacteriana, exceto os possuidores de: epidemiologia, história, exame clínico e/ou liquórico sugestivos de etiologia tuberculosa; história de uso prévio de antibióticos ou corticoterapia, hipertensäo arterial, úlcera ou hemorragia digestiva, alteraçöes renais ou hepáticas; diabetes mellitus; alteraçöes congênitas ou adquiridas do Sistema Nervoso Central e aqueles cujos pais näo concordaram com a inclusäo no estudo. Os participantes receberam, por quatro dias, dexametasona (0,6 mg/kg/dia), intravenosa de seis em seis horas, ou igual ao volume de soluçäo salina isotônica, sendo a primeira dose administrada quinze minutos antes de início da antibioticoterapia. A alocaçäo dos pacientes a cada grupo foi indicada por uma tabela de números aleatórios, gerada por computador, para crianças com idade inferior ou igual a um ano (n=54) e outra tabela para aquelas acima do primeiro ano de vida (n=90), tendo 67 participantes empregado dexametasona e, 77, placebo...
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Child , Dexamethasone/therapeutic use , Haemophilus influenzae/drug effects , Meningitis, Meningococcal/drug therapy , Meningitis, Haemophilus/drug therapy , Neisseria meningitidis/drug effects , Streptococcus pneumoniae/drug effects , Academic DissertationABSTRACT
Among the 157 children with culture proven pyogenic meningitis who were admitted during 1987-1991, in the Department of Child Health at the Christian Medical College and Hospital, Vellore, 40 had H. influenzae type b (HIB) meningitis; 17 of these had multiantimicrobial resistant HIB (MRHIB) and 23 others had usual susceptibility HIB (USHIB) meningitis. The two groups were compared. Children with MRHIB meningitis who received optimal treatment with cefotaxime had excellent recovery. When cefotaxime therapy was delayed, mortality was noted in all except one child who survived with severe neurological sequelae. MRHIB meningitis treated with drugs other than cefotaxime had 100 per cent mortality. Cefotaxime is therefore recommended in children below 3 yr of age presenting with purulent meningitis, as MRHIB is a possible causative agent in this group.
Subject(s)
Anti-Bacterial Agents/pharmacology , Cefotaxime/therapeutic use , Child, Preschool , Chloramphenicol/therapeutic use , Drug Resistance, Microbial , Haemophilus influenzae/drug effects , Humans , Infant , Meningitis, Haemophilus/drug therapy , Microbial Sensitivity Tests , Penicillins/therapeutic use , Species SpecificityABSTRACT
Se reportan cinco casos de Meningitis a H. influenzae "b" resistentes a ampicilina y cloranfenicol, llamándonos la atención de que aunque la resistencia del H. influenza a la ampicilina es de un 2% en nuestro país, la mitad de éstos están asociados también a resistencia al cloranfenicol. A pesar de esta asociación aconsejamos el uso inical de ampicilina y cloranfenicol en el tratamiento de la meningitis purulenta manteniendo la atención para detectar cualquier aumento en la resistencia que oblique a un cambio en la políticia actual
Subject(s)
Infant , Child, Preschool , Humans , Male , Female , Ampicillin/therapeutic use , Chloramphenicol/therapeutic use , Haemophilus influenzae/drug effects , Meningitis, Haemophilus/drug therapy , Drug Resistance, MicrobialABSTRACT
In this paper, we studied the resistance of haemophilus influenzae to the antibiotics by the production of Beta-lactamase. Among the 25 isolated strains from cephalorachidic liquid of newborn babies suffering from purulent meningitis, three are resistant to the ampicilline by producing Beta-lactamase. One of the three samples shows a multiresistance. It is particularly resistant to the chloramphenicol. In the lignt of these results and a review of the litterature, a therapeutic conduct of the H. influenze meningitis is proposed
Subject(s)
Meningitis, Haemophilus/drug therapy , Drug Resistance, Microbial , beta-LactamasesABSTRACT
Entre Abril 3 de 1984 y Marzo 31 de 1986, se estudiaron 95 ninos que ingresaron al Hospital Infantil de Medellin con el diagnostico de meningitis bacteriana aguda (MBA); 68 de ellos fueron menores de 2 anos (71.6%); el haemophilus influenzae tipo B fue el germen predominante (41.0%); le siguieron el streptococcus pneumoniae (27.4%), las enterobacterias (15.8%), la neisseria meningitidis (4.2%),el staphylococcus aureus (3.2%) y estreptococos beta hemiliticso (2.1%); uno de estos fue streptococcus agalactiae y correspondio al primer caso de MBA descrito en Medellin por tal microorganismo; igualmente, se hallo el primer caso colombiano de MBA por shigella. La fiebre, el vomito, la irritabilidad, los signos de irritacion meningea y las convulsiones, fueron las manifestaciones mas frecuentes; en general el cuadro clinico fue mas severo y mayores las complicaciones mientras menor fuera el paciente; los pacientes con convulsiones persistentes de predominio focal tenian, por lo general infarto cerebral, derrame subdural, dilatacion ventricular o una combiancion de los mismos. El origen bacteriano del padecimienyo se pudo comprobar en 89 pacientes (93.7%) mediante una combinacion de examenes directos, cultivos y contrainmunoelectroforesis. La mortalidad general fue de 19.0%; de otro lado el 26% de los pacientes quedo con secuelas tales como convulsiones, deficit motor y sordera. Por primera vez se comprobo en este Hospital resistencia del H. influenzae a la ampicilina ( 3 de las 26 cepas estudiadas). Con base en este y los demas hallazgos se recomiendan modificaciones..
Between aprl13, 1984 and march 31, 1986, 95 children with acute bacterial meningitis (ABM) were admitted to Hospital lnfantil, Medellín, Colombia. 68 (71.6%) were under two years old. Haemophifus influenza type B was the predominant microorganism (41%), followed by Streptococcus pneumoniae (27.4%), enterobacteriaceae (15.8%), Neisseria meningitidis (4.2%), Staphylococcus aureus (3.2%) and betahemolytlc streptococci (2.1%). One case produced by Streptococcus agalactiae was the first one in our Hospital and another one due to Shigella was the first one in Colombia. Bacterial origin was confirmed in 93.7% of the cases, employing direct examination, cultures and counter immuno electrophoresis. The most frequent clinical manifestations were: fever, vomit, irritability, meningeai irritation and seizures; the younger the patient the most severe the clinical picture. Those with persistent focal seizures showed cerebral infarction, subdural effusion, ventricular dilatation or a combination of them. Mortality was 19%; sequelae were observed in 26% (seizure, motor deficit and deafness); Haemophilus influenzae resistance to ampicilin was observed for the first time in this institution. We suggest modifications in the initial therapeutic approach and recommend the suppression of the routine pre-discharge lumbar puncture
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Meningitis/diagnosis , Colombia , Meningitis/mortality , Meningitis/drug therapy , Meningitis/therapy , Meningitis, Haemophilus/drug therapy , Meningitis, Pneumococcal/etiology , Meningitis, Pneumococcal/drug therapy , Meningitis, Pneumococcal/epidemiologyABSTRACT
Os autores pesquisaram, retrospectivamente, 51 casos de meningite bacteriana por Haemophilus influenzae, comprovados por cultura de liquor, em crianças internadas no período de janeiro de 1974 a junho de 1985 no Centro Geral de Pediatria da FHEMIG, em Belo Horizonte. Foram encontrados quatro casos de rash petequial, totalizando 7,8%. A finalidade deste trabalho é salientar a existência de manifestaçöes cutâneas hemorrágicas no quadro clínico de meningite por H. influenzae, e sua importância no diagnóstico diferencial com meningite meningocócica e enteroviroses. Este aspecto deve ser considerado quando da escolha da antibioticoterapia inicial para o tratamento de pacientes com meningite bacteriana
Subject(s)
Infant , Child, Preschool , Humans , Male , Female , Hemorrhage , Meningitis, Haemophilus/diagnosis , Diagnosis, Differential , Meningitis, Haemophilus/drug therapyABSTRACT
Las características clínicas y de laboratorio de una paciente de 5 meses de edad con una septicemia y meningitis por Haemophilus influenzae resistente a ampicilina y cloranfenicol fueron analizados, lo mismo que la respuesta al tratamiento con un nuevo antibiótico en Costa Rica, sulbactam/ampicilina
Subject(s)
Infant , Humans , Female , Ampicillin/therapeutic use , Haemophilus influenzae/drug effects , Meningitis, Haemophilus/drug therapy , Sepsis/drug therapy , Cephalosporins/therapeutic use , Costa RicaABSTRACT
Se realiza un estudio protocolizado para evaluar la eficacia de ceftriaxona a dosis de 100mg/Kg/día cada 24 horas, en el tratamiento de meningitis bacteriana causada por Haemophilus influenzae y gérmenes indeterminados. Se compara con un grupo de testigo de 20 niños afectados de meningitis por Haemophilus influenzae, tratados con la terapéutica convencional (ampicilina y/o cloranfenicol). Los aspectos primordialmente evaluados en ambos grupos para comparar eficacia de tratamiento, fueron los referidos a la negativización bacteriológica y evolución citoquímica del L.C.R. hasta su normalización y consiguiente suspensión del tratamiento, observado en los resultados un comportamiento discretamente más satisfactorio con ceftriaxona. La evolución clínica final en cuanta a las secuelas inmediatas confirmadas y muerte fue similar en ambos grupos. La comprobación de mínimas reacciones adversas y la ventaja indiscutible de sus administración en una sola dosis, destaca a ceftriaxona como un antibiótico adecuado para el tratamiento de meningitis bacteriana a Haemophilus influenzae y gérmenes indeterminados
Subject(s)
Infant , Child, Preschool , Humans , Male , Female , Ampicillin/therapeutic use , Ceftriaxone/therapeutic use , Chloramphenicol/therapeutic use , Meningitis, Haemophilus/drug therapyABSTRACT
Se presenta el caso de un paciente con meningitis por Haemophilus influenzae, productor de beta lactamasa resistente al cloranfenicol. Se revisa la resistencia antibiótica de este germen y las implicaciones terapéuticas en casos similares