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. 2023 Jan-Dec;65(1):e15398.
doi: 10.1111/ped.15398.

Experience with enterococcal meningitis/ventriculitis in children

Ümmühan Çay  1 , Derya Alabaz  1 , Özlem Özgür Gündeşlioğlu  1 , Filiz Kibar  2 , Ceren Çetin  3 , Kadir Oktay  4
Affiliations

Experience with enterococcal meningitis/ventriculitis in children

Ümmühan Çay et al. Pediatr Int. 2023 Jan-Dec.

Abstract

Background: Enterococcal infections are increasingly common in hospitalized patients. Enterococcal meningitis/ventriculitis (EMV) is an extremely rare condition of enterococcal infections, occurring particularly in children. This study investigated the clinical and microbiological characteristics, predisposing factors, and prognosis in pediatric patients with EMV.

Methods: Pediatric patients (<18 years) diagnosed with EMV were retrospectively evaluated over 10 years.

Results: The study included a total of 25 isolates from 24 patients, median age 23 months (range: 1-136 months). The most common symptoms included vomiting, fever, and headache, with hydrocephalus shunt and preterm birth being the two most common conditions. Commonly associated infections, with central nervous system (CNS) devices as a predisposing factor, were due to external ventricular drainage and ventriculoperitoneal shunts. Two patients with spontaneous meningitis were preterm infant. Of the isolates, 44% were Enterococcus faecalis, 44% E. faecium, and 12% E. gallinarum. Five (20%) isolates were vancomycin resistant. Twelve patients were resistant to anti-enterococcal antibiotics, including ampicillin, ciprofloxacin, imipenem, teicoplanin, gentamicin, and linezolid (40%, 20%, 8%, 8%, 4%, and 4%, respectively). Enterococcus faecium was more resistant to ampicillin, ciprofloxacin, teicoplanin, and vancomycin than E. faecalis. The median treatment duration was 17 days (interquartile range: 14-26 days).The mortality rate was 8.3% (2/24; both associated with vancomycin resistance).

Conclusions: Neurosurgical conditions are the most common predisposing factors for EMV. Preterm birth is an important predisposing factor in children. Because EMV is nonspecific in clinical findings, it should be considered when there is an underlying CNS disorder and empirical treatment should begin in this direction.

Keywords: Enterococci; antibiotic resistance; meningitis; therapy; ventriculitis.

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References

REFERENCES

    1. Chase MNJ. Enterococcal and viridans streptococcal infections. Enterococcal infections. In: Cherry JD, Kaplan SL, Steinbach WJ, Hotez PJ, editors. Feigin and Cherry's textbook of pediatric infectious diseases. 8th ed. Philadelphia, PA: Elsevier; 2018. p. 835-50.
    1. Murray BE. The life and times of the enterococcus. Clin Microbiol Rev. 1990;3:46-65.
    1. Murray BE, Miller WR. Treatment of enterococcal infections [Cited 2022 Jan 15]. Available from: http://www.uptodate.com/contents/Treatment-of-enterococcal-infections
    1. Anderson DJ. Vancomycin-resistant enterococci: epidemiology, prevention, and control [Cited 2022 Jan 15]. Available from: http://www.uptodate.com/contents/Vancomycin-resistant-enterococci.epidem... prevention control
    1. Kim SK. Bacterial meningitis beyond the neonatal period. In: Cherry JD, Kaplan SL, Steinbach WJ, Hotez PJ, editors. Feigin and Cherry's textbook of pediatric infectious diseases. 8th ed. Philadelphia, PA: Elsevier; 2018. p. 309-17.

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