Experience with enterococcal meningitis/ventriculitis in children

Area of Science:

• Pediatric Infectious Diseases
• Pediatric Neurology
• Clinical Microbiology

Background:

• Enterococcal infections are a growing concern in hospitalized patients.
• Enterococcal meningitis/ventriculitis (EMV) is a rare but severe infection, particularly affecting children.
• Understanding EMV's characteristics in pediatric populations is crucial for effective management.

Purpose of the Study:

• To investigate the clinical and microbiological features of pediatric EMV.
• To identify predisposing factors and analyze the prognosis of EMV in children.
• To inform diagnostic and treatment strategies for this rare condition.

Main Methods:

• Retrospective evaluation of pediatric patients (<18 years) diagnosed with EMV over a 10-year period.
• Analysis of clinical presentation, predisposing conditions, microbiological isolates, and treatment outcomes.
• Assessment of antibiotic resistance patterns, including vancomycin resistance.

Main Results:

• The study included 24 pediatric patients, with hydrocephalus shunt and preterm birth as common predisposing factors.
• Enterococcus faecalis and E. faecium were the most common causative agents, with 20% of isolates showing vancomycin resistance.
• Mortality rate was 8.3%, with both deaths associated with vancomycin-resistant strains.

Conclusions:

• Neurosurgical conditions and preterm birth are significant predisposing factors for pediatric EMV.
• Non-specific clinical findings necessitate considering EMV in children with underlying central nervous system disorders.
• Early empirical treatment is recommended given the potential severity and resistance patterns observed.