Abstract：Objective To summarize the clinical features of Enterococcus faecium meningitis in children. Methods The clinical data of nine children with Enterococcus faecium meningitis were analyzed. Results In all the nine children, Enterococcus faecium was isolated from blood, cerebrospinal fluid, or peripherally inserted central catheters; 6 (67%) patients were neonates, 2 (22%) patients were younger than 6 months, and 1 (11%) patient was three years and four months of age. In those patients, 56% had high-risk factors before onset, which included intestinal infection, resettlement of drainage tube after surgery for hydrocephalus, skull fracture, perinatal maternal infection history, and catheter-related infection. The main symptoms were fever and poor response. In those patients, 22% had seizures; no child had meningeal irritation sign or disturbance of consciousness. The white blood cell count and level of C-reactive protein were normal or increased; the nucleated cell count in cerebrospinal fluid was normal or mildly elevated; the protein level was substantially elevated; the glucose level was decreased. The drug sensitivity test showed that bacteria were all sensitive to vancomycin and the vancomycin treatment was effective. Only one child had the complication of hydrocephalus. Conclusions Enterococcus faecium meningitis occurs mainly in neonates and infants. The patients have atypical clinical features. A high proportion of patients with Enterococcus faecium meningitis have high-risk factors. Enterococcus faecium is sensitive to vancomycin.
Durand ML, Calderwood SB, Weber DJ, et al. Acute bacterial meningitis in adults——A review of 493 episodes[J]. New Engl J Med, 1993, 328(1):21-28.
[2]
Chandrasekar PH, Brown WJ. Clinical issues of blood cultures[J]. Arch Intern Med, 1994, 154(8):841-849.
[3]
Pintado V, Cabellos C, Moreno S, et al. Enterococcal meningitis:a clinical study of 39 cases and review of the literature[J]. Medicine(Baltimore), 2003, 82(5):346-364.
van de Beek D, Cabellos C, Dzupova O, et al. ESCMID guideline:diagnosis and treatment of acute bacterial meningitis[J]. Clin Microbiol Infect, 2016, 22(Suppl 3):S37-S62.
[9]
Vu J, Carvalho J. Enterococcus:review of its physiology, pathogenesis, diseases and the challenges it poses for clinical microbiology[J]. Front Biol, 2011, 6(5):357-366.
[10]
Inan D, Gunseren F, Colak D, et al. First confirmed case of vancomycin-resistant enterococcus faecium meningitis in Turkey[J]. J Chem, 2004, 16(6):608-611.
[11]
Suara RO, Dermody TS. Enterococcal meningitis in an infant complicating congenital cutis aplasia[J]. Pediatr Infect Dis J, 2000, 19(7):668-669.
[12]
Patel T, Lewis ME, Niesley ML, et al. Postneurosurgical central nervous system infection due to enterococcus faecalis successfully treated with intraventricular vancomycin[J]. Infect Dis Clin Pract (Baltim Md), 2016, 24(3):174-176.
[13]
Emaneini M, Hosseinkhani F, Jabalameli F, et al. Prevalence of vancomycin-resistant enterococcus in Iran:a systematic review and meta-analysis[J]. Eur J Clin Microbiol Infect Dis, 2016, 35(9):1387-1392.
[14]
Edelsberg J, Weycker D, Barron R, et al. Prevalence of antibiotic resistance in US hospitals[J]. Diagn Microbiol Infect Dis, 2014, 78(3):255-262.
