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Updated: Jul 16, 2026

Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid for the Detection of Central Nervous System Pathogens
10:08

Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid for the Detection of Central Nervous System Pathogens

Published on: April 17, 2026

Linezolid cerebrospinal fluid concentration in central nervous system infection

P Malacarne1, B Viaggi, A DI Paolo

  • 1U.O. Anestesia e Rianimazione, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy. pmalacarne@hotmail.com

Journal of Chemotherapy (Florence, Italy)
|February 21, 2007
PubMed

Insights

Linezolid effectively treated central nervous system infections in one case but failed to reach therapeutic cerebrospinal fluid concentrations in another. Monitoring drug levels is recommended for linezolid in CNS infections.

Area of Science:

  • Infectious Diseases
  • Neuroscience
  • Pharmacology

Background:

  • Central nervous system (CNS) infections require effective antimicrobial therapy.
  • Methicillin-resistant Staphylococcus epidermidis (MRSE) can cause severe CNS infections.
  • Linezolid is a potential treatment option for resistant bacterial infections.

Observation:

  • Two cases of MRSE CNS infections treated with linezolid are presented.
  • Case 1: A 72-year-old woman with ventriculitis showed clinical and microbiological improvement with linezolid.
  • Case 2: A 27-year-old man with a cerebral abscess did not achieve detectable cerebrospinal fluid (CSF) linezolid levels despite high serum concentrations.

Findings:

  • Linezolid achieved therapeutic concentrations in CSF in the first case (trough levels > MIC).
  • Linezolid was undetectable in CSF and cerebral tissue in the second case, despite high serum levels.
  • This suggests variable penetration of linezolid into the CNS.

Implications:

  • Linezolid's efficacy in CNS infections may be limited by poor CSF penetration.
  • Monitoring of linezolid drug levels in CSF is crucial for optimizing treatment in CNS infections.
  • Further research is needed to understand factors influencing linezolid's CNS penetration and to guide its use in neuroinfectious diseases.

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