Enterococcal meningitis/ventriculitis in Qatar-Experience with eight patients

Area of Science:

• Infectious Diseases
• Neurology
• Critical Care Medicine

Background:

• Enterococcal meningitis/ventriculitis (EMV) is a rare condition, typically affecting immunocompromised individuals or those with underlying health issues.
• Nosocomial acquisition is a significant concern, particularly in patients with external ventricular drains (EVDs).

Purpose of the Study:

• To describe the clinical characteristics, laboratory findings, treatment strategies, and outcomes of patients diagnosed with EMV.
• To analyze the incidence and risk factors associated with EMV at Hamad General Hospital, Qatar.

Main Methods:

• A retrospective, hospital-based study was conducted.
• Data from patients diagnosed with EMV between 2009 and 2013 were analyzed.

Main Results:

• Eight patients with EMV were identified, with a median age of 42 years; 75% were male.
• Fever was the most common symptom (87.5%). Six patients (75%) developed nosocomial EMV, all associated with EVD placement.
• Enterococcus faecalis was the predominant species (87.5%), with isolates sensitive to ampicillin and vancomycin. All patients received appropriate antibiotics and had EVDs removed, resulting in a 100% cure rate and no mortality.

Conclusions:

• EMV is a recognized complication associated with EVDs, necessitating a high index of suspicion due to nonspecific symptoms.
• Community-acquired enterococcal meningitis can occur in children without apparent risk factors.