[Postsurgery meningitis by Staphylococcus aureus: comparison between methicillin-sensitive and resistant strains].
OBJECTIVE
In recent years, meningitis caused by methicillin-resistant S. aureus has increased. This study was undertaken to compare the clinical characteristics and prognosis of methicillin-resistant S. aureus (MRSA) postneurosurgical meningitis and methicillin-sensible S. aureus (MSSA) postneurosurgical meningitis.


METHODS
Twenty-five episodes of postneurosurgical meningitis due to S. aureus (13 methicillin-resistant strains) seen during a ten-year period were retrospectively reviewed.


RESULTS
Most common underlying diseases were: intracerebral hemorrhage (50% of MRSA patients and 46% of MSSA patients) and neoplasm (53% of MRSA patients and 33% of MSSA patients). Eleven patients (6 of them with MRSA infection) had received antibiotic treatment previously. Thirteen patients were carriers of intraventricular catheters (8 with MRSA infection), 5 wore a ventriculoperitoneal shunt (4 with infections by MSSA), 5 cases had a CSF leakage (4 with infections by MRSA), and one patient with infection by MSSA wore an epidural catheter. Fifteen patients were cured (7 with MRSA infection), and 8 died due to the infection (27% with MSSA infection and 38% with MRSA infection).


CONCLUSIONS
The prognosis of postneurosurgical meningitis by S. aureus does not depend on the presence of resistance to methicillin. Nowadays, the intravenous administration of vancomycin is the treatment of choice in MRSA meningitis.
Rodríguez Guardado
Azucena
A
Unidad de Enfermedades Infecciosas, Hospital Central de Asturias, Oviedo, Spain. cuca22@inicia.es
Maradona Hidalgo
José Antonio
JA
Pérez González
Francisco
F
Cartón Sánchez
José Antonio
JA
Blanco
Armando
A
Rial
Juan Carlos
JC
Asensi Alvarez
Víctor
V
D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy* / Q000453:epidemiology*; D016106:Methicillin Resistance; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011379:Prognosis; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000187:drug effects; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000453:epidemiology*