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[Staphylococcus aureus meningitis with intermediate sensitivity to glycopeptides. Therapeutic indications]
J Pofelski1, P Pavese, J-P Brion
1Service de maladies infectieuses, DMAS, Centre Hospitalier Universitaire de Grenoble.
Introduction:
Since 1997, several observations of glycopeptide intermediate Staphylococcus aureus (GISA) infections have been described. We report the case of meningitis.
Observation:
A 46 year-old man was treated surgically on several occasions for a meningioma of the back cranial fossa. Intracranial hypertension required the placing of a cerebrospinal leading-catheter. He developed a GISA meningitis. Antibiotics and removal of the catheter cured the infection.
Discussion:
To our knowledge, this is the first observation of GISA meningitis. Such infections are rare and are probably underestimated due to the lack of standardized detection methods. They occur in fragile, surgical, immunodeficient patients, often living with prostheses. Prior treatment with vancomycine is often reported. The emergence of these infections is a serious therapeutic problem, since vancomycine is a major antibiotic used in the treatment of meticillin-resistant S. aureus (MRSA) infections.