Related Experiment Videos
[Nosocomial staphylococcal meningitis]
D Mihalache1, V Luca, I Teodorescu
1Clinica de Boli Infecţioase, Facultatea de Medicină, Universitatea de Medicină şi Farmacie Gr. T. Popa, Iaşi.
Objective:
Clinical, bacteriological and therapeutically study on iatrogenic staphylococcal meningitis.
Method:
Retrospective analysis of 33 cases of iatrogenic staphylococcal meningitis admitted to the Hospital of Infectious Diseases of Iaşi in the interval 1988-1997.
Results:
In the interval under study the recorded incidence was 1-5 cases per year. The predisposing factors were neurosurgical procedures for endocranial processes (12 cases), operated chronic otomastoiditis (11 cases), ventriculoatrial or peritoneal shunt (5 cases) and neurosurgical assessment (5 cases). The onset was slow, with persisting and mild headache persistence recurrence of fever, vomiting and convulsions followed by meningeal contracture and encephalitic phenomena. In 24 patients cerebrospinal fluid was typical for purulent meningitis. The causal agents were isolated in 25 cases being Staphylococcus aureus (20 cases) and Staphylococcus epidermidis sensitive to usual antistaphylococcal agents. Three therapeutically schemes were used the association cefotaxim î gentamycin proving to be the most effective vancomycin was required in but 2 cases. Three deaths were recorded.
Conclusions:
The symptoms of iatrogenic staphylococcal meningitis are mild marked by the underlying disease the most effective treatment being the association of cefotaxim with an aminoglycoside.
Insights
Iatrogenic staphylococcal meningitis, often following neurosurgery, presents with mild symptoms. The most effective treatment involves combining cefotaxime with an aminoglycoside, with vancomycin reserved for resistant cases.
Area of Science:
- Infectious Diseases
- Neurology
- Bacteriology
Context:
- Iatrogenic staphylococcal meningitis is a serious complication following neurosurgical interventions.
- This study analyzes 33 cases over a 10-year period (1988-1997).
- Predisposing factors include neurosurgical procedures, chronic otomastoiditis, and shunts.
Purpose:
- To conduct a clinical, bacteriological, and therapeutic study of iatrogenic staphylococcal meningitis.
- To identify predisposing factors and clinical presentation.
- To evaluate treatment efficacy and outcomes.
Summary:
- Retrospective analysis of 33 iatrogenic staphylococcal meningitis cases.
- Staphylococcus aureus and Staphylococcus epidermidis were the primary pathogens, generally sensitive to antibiotics.
- Cefotaxime combined with gentamicin demonstrated the highest efficacy, with vancomycin used in only two cases.
Impact:
- Highlights the importance of early diagnosis and appropriate antibiotic therapy.
- Suggests cefotaxime and aminoglycoside combination as a preferred treatment regimen.
- Provides insights into managing this specific type of meningitis in clinical practice.