Bretón J Rafael, Peset Vicente, Morcillo Francisco, Cano Julia, Sarrión Antonio, Pérez-Belles Carmen, Gobernado Miguel
Servicio de Pediatría. Hospital Universitario Dr. Peset. Valencia. España.
Enferm Infecc Microbiol Clin. 2002 Nov;20(9):443-7.
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.
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.
Enterococci rarely cause bacterial meningitis, though newborns seem more susceptible to this infection. With adequate bactericidal therapy, clinical outcome appears to be generally favorable.
肠球菌是细菌性脑膜炎不常见的病原体，仅占所有病例的0.3% - 4%。新生儿肠球菌性脑膜炎在医学文献中鲜有报道，其表现出的特征与影响其他年龄组（尤其是成年人）的肠球菌性脑膜炎显著不同。
我们回顾性分析了在本中心诊断为肠球菌性脑膜炎的4例新生儿的临床记录。其中2例为早产儿，2例为足月儿。3例患有早发型脑膜炎球菌败血症，1例患有晚发型败血症。感染的危险因素包括1例产妇产时发热、2例早产，伴有在新生儿重症监护病房长时间住院及实施侵入性操作，以及1例婴儿先前接受过抗生素治疗。第4例无明显危险因素。粪肠球菌为3例的病原体，屎肠球菌为1例的病原体。所有肠球菌均对万古霉素敏感。抗生素治疗包括氨苄西林以及氨苄西林与头孢噻肟、氨苄西林与阿米卡星、万古霉素与庆大霉素的联合使用。所有患者均未死亡。
肠球菌很少引起细菌性脑膜炎，不过新生儿似乎对此感染更易感。通过充分的杀菌治疗，临床结局通常似乎较好。
