Exogenous re-infection by a novel Streptococcus pneumoniae serotype 14 as a cause of recurrent meningitis in a child from The Gambia

Martin Antonio,Stephen Howie,Ousman Secka,Claire Oluwalana,Richard A Adegbola,Tumani Corrah

doi:10.1186/1476-0711-8-3

Martin Antonio, Stephen Howie + Show 4 more

Open Access

https://doi.org/10.1186/1476-0711-8-3

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Abstract

We report a case of an infant who experienced exogenous re-infection of Streptococcus pneumoniae serotype 14 as a cause of recurrent meningitis after apparently successful antibiotic treatment with ceftriaxone. eBURST analysis revealed that isolates from the two episodes of meningitis belonged to hypervirulent ST63 and ST3321 clonal complexes respectively.

Highlights

Pneumococcal meningitis is common within the African meningitis belt and occurs in a seasonal pattern indistinguishable from that of meningococcal meningitis [1]
S. pneumoniae serotype14 is a common cause of severe pneumococcal disease in The Gambia and ranks first among 127 pediatric invasive isolates recently tested during a 9-valent pneumococcal conjugate vaccine trial in The Gambia [3]
An eBURST [10] analysis that included the Sequence types (STs) from this study and its single variant locus (SVL) available in the Multilocus sequence typing (MLST) database [11] was performed using the stringent 6/7 identical loci definition. eBURST groups these STs into two major (ST63 and 3321) clonal complexes indicating that these two isolates are unrelated

Summary

Background

Pneumococcal meningitis is common within the African meningitis belt and occurs in a seasonal pattern indistinguishable from that of meningococcal meningitis [1]. A six months old female of the Manjago tribe, from a periurban coastal village in The Gambia was referred from a primary health care facility and admitted to the Royal Victoria Teaching Hospital, Banjul on 6th December 2007 with clinical signs suggestive of meningitis. This diagnosis was confirmed by microscopic examination of the cerebrospinal fluid (CSF), which revealed gram-positive cocci and leucocytosis. On 3rd January 2008, the same child was re-admitted to the Medical Research Council Laboratories Hospital, Fajara again with clinical signs suggestive of meningitis This diagnosis was confirmed by microscopic examination of the (page number not for citation purposes). The MRC microbiology laboratory submits to the external quality assurance programme of the United Kingdom National External Quality Assessment Service [8]

Discussion

Conclusion

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