Successful Treatment of Vancomycin-Resistant Enterococcus Meningitis with Linezolid

Hachem, Ray; Afif, Claude; Gokaslan, Z. L.; Raad, Issam

doi:10.1007/pl00011286

Cited by 52 publications

(37 citation statements)

References 5 publications

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“…similar to those described in investigations conducted with healthy volunteers (14). Even though we documented penetration in only a single pair of measurements, our data confirm the posited high-level CSF concentrations of linezolid (12), which can even exceed serum levels in some cases of meningitis (25). The ratio of the area under the plasma concentrationtime curve to the MIC has been found to be an outcome predictor for treatment of bacteremia with linezolid (B. Cirincione, T. Grasela, S. Sardella, E. Ludwig, D. J. Stalker, B. Hafkin, J.…”

supporting

confidence: 64%

“…This prompted us to start intravenous treatment with linezolid, even though-to our knowledge-there are only two reports on the use of linezolid to treat CSF infections caused by Staphylococcus epidermidis (9,24). There is, however, growing evidence from case series that linezolid is effective against meningitis caused by vancomycin-resistant enterococci (10,12,20,21,24,26).…”

mentioning

confidence: 99%

“…This finding is consistent with the reports of other authors, who found that enterococci disappeared from the CSF after 2 (10, 20) to 4 (26) days of intravenous linezolid. Even though microbiological documentation was not always possible (9,21) and additional antibiotics were applied in most cases (12,20,26), these data are remarkable, especially since linezolid is only bacteriostatic against staphylococci and enterococci (8) and bactericidal antibiotics are usually recommended for the treatment of meningitis (15).…”

mentioning

confidence: 99%

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Treatment of Meningitis Due to Methicillin-Resistant Staphylococcus epidermidis with Linezolid

Krueger¹,

Kottler²,

Will

et al. 2004

J Clin Microbiol

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Methicillin-resistant Staphylococcus epidermidis (MRSE) can cause nosocomial meningitis in the presence of prosthetic devices. Vancomycin is the treatment of choice, but its penetration into the cerebrospinal fluid is poor, especially in cases without severe meningeal inflammation. We successfully used linezolid to treat a case of posttraumatic MRSE meningitis with a low-level inflammatory response. Therapeutic effectiveness was documented microbiologically and by the simultaneous measurement of linezolid levels in serum and cerebrospinal fluid.

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confidence: 64%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Treatment of Meningitis Due to Methicillin-Resistant Staphylococcus epidermidis with Linezolid

Krueger¹,

Kottler²,

Will

et al. 2004

J Clin Microbiol

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“…Less commonly, Enterococcus spp. are involved (7,17). Historically, staphylococcal shunt infections were treated with long courses of intravenous antistaphylococcal antibiotics, such as methicillin (8), with no success.…”

mentioning

confidence: 99%

Action of Linezolid or Vancomycin on Biofilms in Ventriculoperitoneal Shunts In Vitro

Bayston

Ullas

Ashraf

2012

Antimicrob Agents Chemother

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Cerebrospinal fluid (CSF) shunts used to treat hydrocephalus have an overall infection rate of about 10% of operations. The commonest causative bacteria are Staphylococcus epidermidis, followed by Staphylococcus aureus and enterococci. Major difficulties are encountered with nonsurgical treatment due to biofilm development in the shunt tubing and inability to achieve sufficiently high CSF drug levels by intravenous administration. Recently, three cases of S. epidermidis CSF shunt infection have been treated by intravenous linezolid without surgical shunt removal, and we therefore investigated vancomycin and linezolid against biofilms of these bacteria in vitro. A continuous-perfusion model of shunt catheter biofilms was used to establish mature (1-week) biofilms of Staphylococcus aureus, Staphylococcus epidermidis (both methicillin resistant [MRSA and MRSE]), Enterococcus faecalis, and Enterococcus faecium. They were then "treated" with either vancomycin or linezolid in concentrations achievable in CSF for 14 days. The biofilms were then monitored for 1 week for eradication and for regrowth. Enterococcal biofilms were not eradicated by either vancomycin or linezolid. Staphylococcal biofilms were eradicated by both antibiotics after 2 days and did not regrow. No resistance was seen. Linezolid at concentrations achievable by intravenous or oral administration was able to eradicate biofilms of both S. epidermidis (MRSE) and S. aureus (MRSA). Neither vancomycin at concentrations achievable by intrathecal administration nor linezolid was able to eradicate enterococcal biofilms. It is hoped that these in vitro results will stimulate further clinical trials with linezolid, avoiding surgical shunt removal.

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“…and oral administration and has proven effective in the treatment of infections caused by methicillin-resistant staphylococcal species in critically ill patients. 12 Intravenous linezolid also appears to be a safe and effective therapy for vancomycin-resistant enterococcus meningitis [13][14][15] and linezolid achieved sufficient CSF concentrations to bring about clinical and bacteriological cure. 16,17 Based on our experience and the data reported to date, i.t.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of meningoencephalitis caused by methicillin-resistant Staphylococcus aureus with intrathecal vancomycin in an allogeneic peripheral blood stem cell transplant recipient

Matsubara

Makimoto

Higa

et al. 2003

Bone Marrow Transplant

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Summary:Methicillin-resistant Staphylococcus aureus (MRSA) is a common infectious pathogen during stem cell transplantation. We report a case of meningoencephalitis with multiple abscess formation caused by MRSA, which occurred in a 4-year-old boy soon after allogeneic peripheral blood stem cell transplantation. We successfully cured the infection with a combination of intravenous and intrathecal vancomycin.

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Successful Treatment of Vancomycin-Resistant Enterococcus Meningitis with Linezolid

Cited by 52 publications

References 5 publications

Treatment of Meningitis Due to Methicillin-Resistant Staphylococcus epidermidis with Linezolid

Treatment of Meningitis Due to Methicillin-Resistant Staphylococcus epidermidis with Linezolid

Action of Linezolid or Vancomycin on Biofilms in Ventriculoperitoneal Shunts In Vitro

Successful treatment of meningoencephalitis caused by methicillin-resistant Staphylococcus aureus with intrathecal vancomycin in an allogeneic peripheral blood stem cell transplant recipient

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