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Device-Associated Meningitis by Linezolid-Resistant Staphylococcus haemolyticus in a Vancomycin- Hypersensitive

Priya Vijayan1, Dwarakanath Srinivas2, Nagarathna Siddaiah1

  • 1Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.

Journal of Neurosciences in Rural Practice
|December 14, 2019
PubMed

Insights

This case report details a rare instance of meningitis caused by multidrug-resistant Staphylococcus haemolyticus, which was resistant to both methicillin and linezolid. The patient improved with cotrimoxazole, highlighting the need for careful antibiotic use.

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Medical Case Reports

Background:

  • Device-related meningitis poses treatment challenges, particularly with multidrug-resistant bacteria.
  • Coagulase-negative staphylococci are common causes of healthcare-associated infections.
  • Linezolid resistance in staphylococci is an emerging concern.

Observation:

  • A rare case of drain-associated meningitis caused by methicillin- and linezolid-resistant Staphylococcus haemolyticus is presented.
  • The patient had vancomycin hypersensitivity, complicating initial treatment strategies.
  • The infection occurred following linezolid therapy.

Findings:

  • Linezolid resistance was attributed to a G2576T mutation in the 23S rRNA gene and the presence of the cfr gene.
  • Cotrimoxazole therapy led to clinical improvement in the vancomycin-hypersensitive patient.
  • This represents a unique instance of Staphylococcus haemolyticus exhibiting resistance to both methicillin and linezolid.

Implications:

  • Highlights the importance of monitoring linezolid use to prevent the spread of resistance.
  • Emphasizes the need for comprehensive perioperative care to prevent healthcare-associated infections.
  • Suggests cotrimoxazole as a potential treatment option for specific resistant staphylococcal infections.
Keywords:
G2576T mutationS. haemolyticuscfr genelinezolid resistancepostsurgical meningitisvancomycin hypersensitive

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