[Neonatal meningitis due to Enterococcus spp.: presentation of four cases].
OBJECTIVE
Enterococci are unusual etiologic agents of bacterial meningitis and account for only 0.3-4% of all cases. Neonatal enterococcal meningitis, which is rarely reported in the medical literature, presents characteristics that are significantly different from enterococcal meningitis affecting other age groups, particularly adults.


METHODS
We retrospectively reviewed the clinical records of four newborns diagnosed with enterococcal meningitis in our center. Two were premature and two were term infants. Three were affected with early-onset meningococcal sepsis and one with late-onset sepsis. Risk factors for infection included intrapartum maternal fever in one case and prematurity in two cases, with prolonged stay in the neonatal intensive care unit and application of invasive procedures, and prior antibiotic treatment in one of infant. There were no apparent risk factors in the fourth case. Enterococcus faecalis was the causal agent in three cases and Enterococcus faecium in one. None of the enterococci were vancomycin-resistant. Antibiotic treatment included ampicillin and combinations of ampicillin and cefotaxime, ampicillin and amikacin, and vancomycin and gentamicin. None of the patients died.


CONCLUSIONS
Enterococci rarely cause bacterial meningitis, though newborns seem more susceptible to this infection. With adequate bactericidal therapy, clinical outcome appears to be generally favorable.
Bretón
J Rafael
JR
Servicio de Pediatría. Hospital Universitario Dr. Peset. Valencia. España. breton_raf@gva.es
Peset
Vicente
V
Morcillo
Francisco
F
Cano
Julia
J
Sarrión
Antonio
A
Pérez-Belles
Carmen
C
Gobernado
Miguel
M
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004198:Disease Susceptibility; D013293:Enterococcus faecalis / Q000302:isolation & purification; D016984:Enterococcus faecium / Q000302:isolation & purification; D005260:Female; D005334:Fever; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal; D007902:Length of Stay; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D007744:Obstetric Labor Complications; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D014621:Vagina / Q000382:microbiology
D000900:Anti-Bacterial Agents