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

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 identi...

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Published inClinical infectious diseases Vol. 37; no. 2; pp. 159 - 166
Main Authors Parodi, Stephen, Lechner, Arno, Osih, Regina, Vespa, Paul, Pegues, David
Format Journal Article
LanguageEnglish
Published Chicago, IL The University of Chicago Press 15.07.2003
University of Chicago Press
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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.
AbstractList 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.
Author Vespa, Paul
Pegues, David
Lechner, Arno
Osih, Regina
Parodi, Stephen
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Issue 2
Keywords Human
Nosocomial infection
Nervous system diseases
Prognosis
Infection
Clinical management
Enterobacter
Treatment
Central nervous system disease
Risk factor
Bacteriosis
Bacteria
Meningitis
Enterobacteriaceae
Language English
License CC BY 4.0
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Notes istex:FBA0D2EC3C7D83A47AD8593549B0020AC6019A19
Present affiliation: Infectious Diseases Unit, General Hospital Salzburg, Salzburg, Austria (A.L.), and Department of Medicine, Good Samaritan Hospital, Baltimore, Maryland (R.O.).
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Snippet Enterobacter species are increasingly a cause of nosocomial meningitis among neurosurgery patients, but risk factors for these infections are not well defined....
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StartPage 159
SubjectTerms Adult
Aged
Anti-Bacterial Agents - therapeutic use
Antimicrobials
Bacterial diseases
Bacterial diseases of the nervous system. Bacterial myositis
Bacterial meningitis
Biological and medical sciences
Cephalosporins
Cross Infection - cerebrospinal fluid
Cross Infection - drug therapy
Cross Infection - epidemiology
Drains
Enterobacter
Enterobacter - drug effects
Enterobacter - isolation & purification
Enterobacteriaceae Infections - cerebrospinal fluid
Enterobacteriaceae Infections - drug therapy
Enterobacteriaceae Infections - epidemiology
Female
Human bacterial diseases
Humans
Infections
Infectious diseases
Major Articles
Male
Median nerve
Medical sciences
Meningitis
Meningitis, Bacterial - cerebrospinal fluid
Meningitis, Bacterial - drug therapy
Meningitis, Bacterial - epidemiology
Middle Aged
Multivariate Analysis
Predisposing factors
Risk Factors
Statistical median
Treatment Outcome
Title Nosocomial Enterobacter Meningitis: Risk Factors, Management, and Treatment Outcomes
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https://www.jstor.org/stable/4462417
https://www.ncbi.nlm.nih.gov/pubmed/12856206
https://search.proquest.com/docview/18875532
https://search.proquest.com/docview/73474094
Volume 37
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