Article in Japanese

A case of neonatal Streptococcus pneumoniae serotype 11A／E infection

Akiyoshi NARIAI, Toru UCHIMURA, Taichi KANETAKA

This study reports a boy presenting intrauterine Streptococcus pneumoniae infection with neonatal asphyxia followed by dyspnea. He was born transvaginally 15 hours after membrane rupture at 38 weeks' gestation. Colonies of α hemolysis were found to grow on the sheep-blood agar plates of the nasopharynx, skin and stool, one day after the initiation of ampicillin (ABPC). As Gram staining of the colonies revealed gram-positive diplococci, a diagnosis of neonatal S. pneumoniae infection was made. Then, a cerebrospinal fluid (CSF) was obtained, which revealed normal cell counts, a negative Gram staining and a negative latex agglutination test result, but a positive BinaxNOW^® S. pneumoniae antigen test result. ABPC was withdrawn after two weeks with a good outcome. However, S. pneumoniae PCR, based on amplification of the lytA gene on the CSF sample, gave a negative result. Therfore, pneumococcal meningitis was ruled out.
An S. pneumoniae isolate was obtained from the nasopharynx of the patient's two-year old brother. The viginal culture from his mother was negative, but the BinaxNOW^® S. pneumoniae antigen test for maternal urine samples gave a positive result. The S. pneumoniae isolates obtained from the boy and his brother revealed the same serotype, 11A／E, and sequence type, 99, susceptible to penicillin G.

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Department of Pediatrics, Yokohama Minami Kyosai Hospital

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Received	April 4, 2013
Accepted	June 6, 2013

25 (3)：263─268,2013