CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(04): 714-718
DOI: 10.4103/ajns.AJNS_144_21
Original Article

Adult coagulase-negative staphylococcal meningitis in Qatar: Clinical characteristics and therapeutic outcomes

Fahmi Khan
Department of Medicine, Hamad General Hospital, Doha, Qatar
› Institutsangaben

Background and Objectives: Coagulase-negative staphylococci (CoNS) have emerged as a major pathogen in nosocomial meningitis. This study was designed to describe the clinical profile, laboratory parameters, treatment, and outcomes of CoNS meningitis in patients admitted to Hamad General Hospital, Qatar. Materials and Methods: This retrospective hospital-based study described the patients with CoNS meningitis from 2009 to 2013. Results: Twelve patients were recruited for the study, of which there were 10 (83.3%) males and 2 (16.7%) females with a median age of 39 years (interquartile range [IQR]: 29–46 years). Fever was the most common presenting symptom being present in all patients, followed by mental alterations 7 (58.3%). All CoNS meningitis cases in this study were nosocomially acquired after neurosurgery and in most cases after external ventricular drain (EVD) insertion. The median time between the procedure and acquisition of infection was 13 days (IQR: 10–15.7 days). The isolated species include 8 (66.7%) Staphylococcus epidermidis, 2 (16.7%) Staphylococcus capitis, and 2 (16.7%) Staphylococcus haemolyticus. All CoNS isolates were sensitive to vancomycin while 75% of them were oxacillin resistance. In the eight patients with EVDs, the infected EVDs were removed, while all patients received empirical antibiotics involving mainly vancomycin and ceftriaxone that were modified upon receipt of culture results. All patients were cured, and no mortality was reported. Conclusions: CoNS meningitis is a recognized complication related to the introduction of neurosurgical devices. Because of its nonspecific clinical presentation, treating physicians should have a high suspicion index. If CoNS meningitis is highly suspected, vancomycin is the empirical treatment of choice while awaiting results of sensitivity.

Financial support and sponsorship

Nil.




Publikationsverlauf

Eingereicht: 09. April 2021

Angenommen: 06. Juli 2021

Artikel online veröffentlicht:
16. August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Azimi T, Mirzadeh M, Sabour S, Nasser A, Fallah F, Pourmand MR. Coagulase-negative staphylococci (CoNS) meningitis: A narrative review of the literature from 2000 to 2020. New Microbes New Infect 2020;37:100755.
  • 2 Khan FY, Abu-Khattab M, Almaslamani EA, Hassan AA, Mohamed SF, Elbuzdi AA, et al. Acute Bacterial meningitis in qatar: A hospital-based study from 2009 to 2013. Biomed Res Int 2017;2017:2975610.
  • 3 Chang WN, Lu CH, Huang CR, Chuang YC, Tsai NW, Chen SF, et al. Epidemiology of adult staphylococcal meningitis in southern Taiwan: A clinical comparison of Staphylococcus aureus infection and coagulase-negative staphylococcal infection. Jpn J Infect Dis 2007;60:262-6.
  • 4 Durand ML, Calderwood SB, Weber DJ, Miller SI, Southwick FS, Caviness VS Jr., et al. Acute bacterial meningitis in adults. A review of 493 episodes. N Engl J Med 1993;328:21-8.
  • 5 Huang CR, Lu CH, Wu JJ, Chang HW, Chien CC, Lei CB, et al. Coagulase-negative staphylococcal meningitis in adults: Clinical characteristics and therapeutic outcomes. Infection 2005;33:56-60.
  • 6 Zheng G, Li S, Zhao M, Yang X, Zhang Y, Deng J, et al. Time to positive culture can differentiate post-neurosurgical coagulase-negative Staphylococci other than S epidermidis meningitis from contamination: A case-control observational study. J Clin Lab Anal 2020;34:e23447.
  • 7 Oud L. Community-acquired meningitis due to Staphylococcus capitis in the absence of neurologic trauma, surgery, or implants. Heart Lung 2011;40:467-71.
  • 8 Drinkovic D, Pottumarthy S, Knight D, Morris AJ. Neonatal coagulase-negative staphylococcal meningitis: A report of two cases. Pathology 2002;34:586-8.
  • 9 von Eiff C, Peters G, Heilmann C. Pathogenesis of infections due to coagulase-negative staphylococci. Lancet Infect Dis 2002;2:677-85.
  • 10 Davidson RJ, Low DE. Staphylococcus epidermidis and other coagulase-negative staphylococci. In: Yu VL, Weber R, Raoult D, editors. Antimicrobial Therapy and Vaccines. New York: Apple Trees Productions; 2002. p. 659-73.