Enterococcal Meningitis/Ventriculitis: A Tertiary Care Experience.

Area of Science:

• Infectious Diseases
• Neurology
• Microbiology

Background:

• Enterococcal meningitis is an exceedingly rare form of bacterial meningitis.
• Clinical outcomes for enterococcal meningitis are highly variable.
• This condition is infrequently encountered in clinical practice.

Purpose of the Study:

• To investigate the clinical characteristics of enterococcal meningitis.
• To analyze therapeutic strategies and antimicrobial susceptibility profiles.
• To determine patient outcomes in a tertiary care setting.

Main Methods:

• Retrospective review of medical records over a four-year period (2013-2016).
• Inclusion of all patients diagnosed with enterococcal meningitis.
• Evaluation of clinical and laboratory data.

Main Results:

• Six cases identified (three infants, three adults), all post-neurosurgical procedures.
• Four patients had existing central nervous system (CNS) devices.
• Predominant resistance to ampicillin, amoxicillin-clavulanate, and oxytetracycline; two isolates resistant to vancomycin.
• Vancomycin used for sensitive cases; linezolid (with or without rifampicin) for vancomycin-resistant enterococcal (VRE) meningitis.
• CNS device removal performed in all cases; no mortality observed.

Conclusions:

• Enterococcal meningitis is uncommon and frequently associated with neurosurgical interventions.
• Early and appropriate treatment, alongside CNS device removal, is crucial for successful clinical outcomes.
• This study highlights the importance of antimicrobial stewardship and device management in managing enterococcal meningitis.