Related Experiment Videos

Vancomycin-resistant Enterococcus faecalis colonization during recovery from Neisseria meningitidis cerebrospinal

M Knausz1, B Gartner, I Fömötör

  • 1Clinical Microbiology, Intensive Care Unit and Plastic Surgery Department, Petz Aladár County Teaching Hospital, Gyór, Hungary.

Acta Microbiologica Et Immunologica Hungarica
|January 31, 2004
PubMed

Insights

A severe Neisseria meningitidis infection led to septic shock in a young man, complicated by vancomycin-resistant Enterococcus faecalis (VREF) wound infection. This case highlights VREF as a significant nosocomial pathogen in immunocompromised patients.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • A 19-year-old male presented with septic shock and widespread skin suffusions, initially caused by Neisseria meningitidis serogroup C.
  • The patient experienced two superinfectious episodes during his recovery period, indicating a compromised immune state.

Observation:

  • A vancomycin-sensitive Enterococcus faecium bacteremia occurred during the stabilization phase.
  • A subsequent wound infection in the heel revealed vancomycin-resistant Enterococcus faecalis (VREF), carrying the vanA gene, alongside Gram-negative opportunistic pathogens.

Findings:

  • The case details the successful management of a complex infection involving Neisseria meningitidis and VREF.
  • The presence of the vanA gene confirmed the mechanism of vancomycin resistance in the Enterococcus faecalis strain.

Implications:

  • This report underscores the emergence of VREF as a challenging nosocomial pathogen, particularly in patients with severe underlying conditions.
  • Effective systemic and topical treatments, coupled with surgical interventions, were crucial for patient recovery.
  • This is the second reported instance of VREF colonization or infection in Hungary, emphasizing the need for vigilant surveillance and infection control measures.

Related Concept Videos

Bacterial Meningitis01:24

Bacterial Meningitis

Bacterial meningitis is a severe infectious disease involving inflammation of the meninges, the protective membranes surrounding the brain and spinal cord. It occurs when pathogenic bacteria cross the blood–brain barrier and enter the cerebrospinal fluid. Common causative organisms include Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, Listeria monocytogenes, and Escherichia coli K1. The exact route of entry varies by pathogen and host condition.Routes of Entry...
Bacterial Meningitis II: Pathophysiology01:26

Bacterial Meningitis II: Pathophysiology

Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
Bacterial Meningitis I: Introduction01:22

Bacterial Meningitis I: Introduction

Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
Cryptococcal Meningitis01:27

Cryptococcal Meningitis

Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
Clinical Significance of Antibiotic Resistance01:25

Clinical Significance of Antibiotic Resistance

Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...
Viral Meningitis01:18

Viral Meningitis

Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...