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Journal Article 2007; 28(Suppl 2): 34-35 PubMed PMID: 17558376 Citation  Keywords:  Anti-Bacterial Agents:therapeutic use, Child, Child, Preschool, Cross Infection:drug therapy, Humans, Infant, Infant, Newborn, Meningitis, Bacterial:drug therapy, Neurosurgical Procedures:adverse effects, Postoperative Complications:drug therapy, Retrospe.   

: Analysing 101 cases of nosocomial meningitis due to staphylococci other than S. aureus within last 15 years, coagulase negative staphylococci represented the commonest pathogen. Major risk factor for staphylococcal meningitis was prior neurosurgery, mainly ventriculoperitoneal shunt insertion. Ten of 101 cases were caused by glycopeptide intermediate resistant strains in patients pretreated with multiple combination of antibiotics including vancomycin and shunt exchanges: 76% of strains were also oxacillin resistant....

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Journal Article 2007; 28(Suppl 2): 32-33 PubMed PMID: 17558375 Citation  Keywords:  Anti-Bacterial Agents:therapeutic use, Cross Infection:drug therapy, Enterococcus faecalis:pathogenicity, Gram-Positive Bacterial Infections:complications, Humans, Infant, Newborn, Infant, Very Low Birth Weight, Meningitis, Bacterial:drug therapy, Neurosu.   

: Enterococcal meningitis is a rare complication of neurosurgical procedure or high technology treatment of children and occurs mainly imunocompromised neonates with very low birth weight, severe prematurity and complicates sometime ventriculoperitoneal shunt insertion or perinatal trauma. E. faecalis caused 10 nosocomial meningitis and all strains were susceptible to vancomycin and chloramphenicol, and in our database 90% also to gentamicin and ampicillin. Mortality in our group of 10 children was 20% what is insignificantly higher than overall mortality in the whole cohort of meningitis within last 15 years in our database (15.1%). Early empiric therapy should include also ampicillin or vancomycin, if enterococcal etiology is suspected....

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Journal Article 2007; 28(Suppl 2): 30-31 PubMed PMID: 17558374 Citation  Keywords:  Anti-Bacterial Agents:therapeutic use, Cross Infection:drug therapy, Humans, Hydrocephalus:etiology, Infant, Newborn, Language Development Disorders:etiology, Meningitis, Bacterial:drug therapy, Rare Diseases, Retrospective Studies, Streptococcal Infectio.   

: Streptococcus agalactiae is a rare cause of neonatal meningitis in the era of peripartum prophylaxis with prophylaxis with ampicillin in colonized/infected mothers. However 5 cases of meningitis among 171 cases of pediatric nosocomial meningitis database within last 15 years occurred. All 5 children were neonates (one VLBW and early gestation newborn), 2 after neurosurgery. All 5 cases were successfully cured with a combination of cefotaxim (or ceftazidim) plus aminoglycosides, in one case also with addition of vancomycin or ampicillin. However 3 of 5 cured patients had neurologic sequellae, two of them reversible hydrocephalus and in speech retardation....

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Journal Article 2007; 28(Suppl 2): 27-29 PubMed PMID: 17558373 Citation  Keywords:  Anti-Bacterial Agents:therapeutic use, Child, Child, Preschool, Cross Infection:drug therapy, Drug Resistance, Bacterial, Enterobacteriaceae Infections:complications, Female, Humans, Infant, Infant, Newborn, Male, Meningitis, Bacterial:drug therapy, Risk .   

: Nosocomial neuroinfections due to Enterobacteriaceae represented 9.5% in our cohort of 171 cases of paediatric meningitis within last 15 years. Commonest etiologic agents was E. coli - 9 (50%) followed by Klebsiella pneumoniae - 3 (16,7%) and Enterobacter cloacae. Citrobacter freundii, Proteus mirabilis and Salmonella enteritidis (1 each). Commonest risk factors were neonatal age 13 - (72.2%), very low birth weight 5 (27.8%), craniocerebral trauma - 4 (22.2%) and neurosurgery - 5 (27.8%). All but 1 case were treated with antibiotics: 8 with III-rd and 3 with IV-th generation cephalosporins (ceftazidim, cefotaxim and cefepim) 2 with meropenem and 4 with ciprofloxacin: Nosocomial meningitis due to enterobacteriaceae was associated with significantly high mortality (29.9% vs. 15.1% in all cohort of pediatric meningitis - p<0.02)....

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Journal Article 2007; 28(Suppl 2): 22-24 PubMed PMID: 17558371 Citation  Keywords:  Aneurysm, Infected:etiology, Anti-Infective Agents:therapeutic use, Bacterial Infections:complications, Brain:microbiology, Central Nervous System Diseases:etiology, Cerebrovascular Disorders:etiology, Endocarditis:complications, Humans, Meningitis:etiolo.   

: Neurologic complications of infective endocarditis, risk factors for mortality and neurologic sequellae are briefly reviewed....

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Journal Article 2007; 28(Suppl 2): 20-21 PubMed PMID: 17558370 Citation  Keywords:  Adolescent, Anti-Bacterial Agents:therapeutic use, Cefotaxime:therapeutic use, Ceftazidime:therapeutic use, Chi-Square Distribution, Child, Preschool, Chloramphenicol:therapeutic use, Cross Infection:drug therapy, Drug Therapy, Combination, Female, Gentam.   

: Risk factors, therapy and outcome of 15 cases of nosocomial meningitis due to Pseudomonas aeruginosa is reviewed. No difference in risk factors was found, however mortality for Ps. aeruginosa was significantly higher (33.3 vs 15.1% p<0.04)....

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Letter 2007; 28(Suppl 2): 20-21 PubMed PMID: 17558369 Citation  Keywords:  Aminoglycosides:therapeutic use, Anti-Bacterial Agents:therapeutic use, Carbapenems:therapeutic use, Child, Child, Preschool, Cross Infection:drug therapy, Drug Therapy, Combination, Humans, Infant, Infant, Newborn, Meningitis, Bacterial:drug therapy, Ret.   

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Comparative Study 2007; 28(Suppl 2): 17-18 PubMed PMID: 17558368 Citation  Keywords:  Aminoglycosides:administration & dosage, Anti-Bacterial Agents:administration & dosage, Carbapenems:administration & dosage, Child, Child, Preschool, Cross Infection:drug therapy, Drug Therapy, Combination, Glycopeptides:administration & dosage, Humans, I.   

: We have been unable to document a benefit of a combination of aminoglycosides with betalactam or carbapenem antibiotics in nosocomial meningitis. This was similar to the cases of sepsis, where survival of patients did not improve with combination therapy. Combination therapy did not increase the chance of appropriateness of the therapy. 30% of those on combination therapy were considered as inappropriately treated in comparison to 2.8% of those on monotherapy (p<0.01)....

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