Nosocomial Enterobacter Meningitis: Risk Factors, Management, and Treatment Outcomes

Abstract

Enterobacter species are increasingly a cause of nosocomial meningitis among neurosurgery patients, but risk factors for these infections are not well defined. A review of all adult patients hospitalized at the University of California-Los Angeles (UCLA) Medical Center during an 8-year period identified 15 postneurosurgical cases of Enterobacter meningitis (EM). Cure was achieved in 14 cases (93%), and efficacy was similar for carbapenem- and cephalosporin-based treatment. A matched case-control study comparing 26 controls with 13 case patients hospitalized exclusively at the UCLA Medical Center found that external cerebrospinal fluid (CSF) drainage devices (odds ratio [OR], 21.8; P=.001), isolation of Enterobacter species from a non-CSF culture (OR, 24.6; P=.002), and prolonged administration of antimicrobial drugs before the diagnosis of meningitis that were inactive in vitro against Enterobacter species (OR, 13.3; P=.008) were independent risk factors for EM. Despite favorable treatment outcomes, EM is a serious infection associated with Enterobacter species colonization or infection at other surgical sites, with selective antimicrobial pressure, and with invasive CNS devices.

Isolation of Salmonella species and some other gram negative bacteria from rats cohabitating with poultry in Ibadan, Oyo State, Nigeria

“…Likewise, Enterobacter species have been reported to cause disease in poultry (Nandi et al, 2013), it has also been isolated form egg shell of poultry together with other pathogenic Enterobacterecea (Musgrove et al, 2008). Some species of Enterobacter have also been isolated from patients' cerebrospinal fluid (Parodi et al, 2003).…”

Serratia marcescens meningitis: Epidemiology, prognostic factors and treatment outcomes

“…14,19 The predominant antibiotic regimen was defined as the antibiotic used for at least two-thirds of the patient's treatment course. 14 Clinical outcomes were determined by the GCS change and mortality.…”

“…There were only case reports in patients with a history of head trauma, neurosurgical procedures, mastoiditis or chronic sinusitis. 9e13 Prosthetic devices, including external cerebrospinal fluid (CSF) drainage catheters 14 and ventriculoperitoneal (VP) shunts, 11,15 facilitate bacterial colonization and provide a potential route into the CNS, eventually causing meningitis. The use of external ventricular drains (EVDs) or VP shunts might develop an environment associated with a relatively high risk for postneurosurgical CNS infections.…”

Post Traumatic Meningitis in Neurosurgery Department

“…Some other studies have demonstrated Streptococcus pneumonia is the most common pathogen in post-surgical meningitis [6] , however the incidence of S. pneumonia observed more in the children [12] . Parodi and co-workers reported that the proportion of cases of nosocomial meningitis due to gram-negative organisms appears to be increasing, they revealed the entrobacters grew rapidly as the cause of nosocomial meningitis [11] . This study expressed our finding to Klebsiella.…”