• There is increasing concern about antibiotic resistance in meningitis infections
• In the US, a five-month-old baby with meningitis recently proved to be resistant to standard antibiotic treatment
• Researchers say this calls for closer partnerships between infectious disease doctors and microbiology labs

Antibiotic-resistant bacteria affected the treatment of meningitis at a major children’s hospital in Washington, D.C.

This single case at Children’s National Hospital raises concerns about drug resistance in the common bacterium that caused the infection, and researchers say it could change lab and clinical procedures around the world.

Normally, when doctors first suspect meningitis in children, they usually give the broad-spectrum antibiotic ceftriaxone, which acts against a wider range of disease-causing bacteria. When the meningitis organism is identified through lab tests, penicillin or ampicillin are used, the researchers explained.

People who have had close contact with the patients are also given ciprofloxacin as a precaution.

Inappropriate treatment

In this case, a five-month-old baby was taken to the emergency room after six days of fever and congestion. The infant’s particular meningitis contained an enzyme that makes the germ resistant to penicillin and ampicillin, and also to ciprofloxacin.

The hospital sent samples of the resistant bacteria to several health agencies, including the US Centers for Disease Control and Prevention, to compare with other samples.

“These bacteria wouldn’t have been susceptible to the common antibiotics that we would normally use for this infection, so it’s entirely possible that the infections caused by these bacteria could have been treated inappropriately if doctors used the standard protocol,” co-author Dr Gillian Taormina said in a hospital news release. She is a fellow in paediatric infectious diseases.

Taormina said the baby’s condition improved after seven days on ceftriaxone. Relatives and other contacts were treated with the antibiotic rifampin.

Close partnerships

Although this case had a good outcome, it underscores increasing concern about antibiotic resistance in other meningitis infections.

Taormina and co-author Joseph Campos said the growing number of antibiotic-resistant bacteria calls for close partnerships between infectious disease doctors and microbiology labs. Campos is director of the hospital’s Infectious Diseases Molecular Diagnostics Laboratory.

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