Journal of Pediatric Intensive Care, Table of Contents J Pediatr Intensive Care 2019; 08(02): 100-102DOI: 10.1055/s-0038-1672194 Case Report Georg Thieme Verlag KG Stuttgart · New York Ventriculoperitoneal Shunt Infection Caused by Enterococcus gallinarum in a Pediatric Patient: A Case Report Kacie Clark 1 Department of Pharmacy, Florida Hospital Orlando, Orlando, Florida, United States , Deborah Maka 2 Department of Pediatric Pharmacy, Florida Hospital for Children, Orlando, Florida, United States › Author Affiliations Recommend Article Abstract Buy Article Abstract Enterococcus gallinarum is a common colonizer of the gastrointestinal tract that expresses intrinsic vancomycin resistance. This case report describes an E. gallinarum ventriculoperitoneal (VP) shunt infection in a pediatric patient. A 4-year-old female patient presented with cerebrospinal fluid (CSF) cultures from a VP shunt significant for E. gallinarum. The patient received ampicillin and synergistic gentamicin. She completed a total of 16 days of therapy following 2 weeks of negative CSF and blood cultures with full clinical cure of infection. The patient was successfully treated following a 2-week course of antibiotics. Awareness of Enterococcus species with intrinsic vancomycin resistance should be increased. Keywords Keywords Enterococcus - ventriculoperitoneal shunt - meningitis Full Text References References 1 Monticelli J, Knezevich A, Luzzati R, Di Bella S. Clinical management of non-faecium non-faecalis vancomycin-resistant enterococci infection. Focus on Enterococcus gallinarum and Enterococcus casseliflavus/flavescens . J Infect Chemother 2018; 24 (04) 237-246 2 The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 8.1, 2018. Available at: http://www.eucast.org 3 Brown DF, Hope R, Livermore DM. , et al; BSAC Working Parties on Resistance Surveillance. Non-susceptibility trends among enterococci and non-pneumococcal streptococci from bacteraemias in the UK and Ireland, 2001-06. J Antimicrob Chemother 2008; 62 (Suppl. 02) ii75-ii85 4 Britt NS, Potter EM. Clinical epidemiology of vancomycin-resistant Enterococcus gallinarum and Enterococcus casseliflavus bloodstream infections. J Glob Antimicrob Resist 2016; 5: 57-61 5 Choi SH, Lee SO, Kim TH. , et al. Clinical features and outcomes of bacteremia caused by Enterococcus casseliflavus and Enterococcus gallinarum: analysis of 56 cases. Clin Infect Dis 2004; 38 (01) 53-61 6 Reid KC, Cockerill III FR, Patel R. Clinical and epidemiological features of Enterococcus casseliflavus/flavescens and Enterococcus gallinarum bacteremia: a report of 20 cases. Clin Infect Dis 2001; 32 (11) 1540-1546 7 Takayama Y, Sunakawa K, Akahoshi T. Meningitis caused by Enterococcus gallinarum in patients with ventriculoperitoneal shunts. J Infect Chemother 2003; 9 (04) 348-350 8 Li X, Fan S, Lin X. , et al. The first case report of Enterococcus gallinarum meningitis in neonate: a literature review. Medicine (Baltimore) 2018; 97 (07) e9875 9 Antonello VS, Zenkner FM, França J, Santos BR. Enterococcus gallinarum meningitis in an immunocompetent host: a case report. Rev Inst Med Trop São Paulo 2010; 52 (02) 111-112 10 Kurup A, Tee WS, Loo LH, Lin R. Infection of central nervous system by motile Enterococcus: first case report. J Clin Microbiol 2001; 39 (02) 820-822 11 Iaria C, Stassi G, Costa GB, Di Leo R, Toscano A, Cascio A. Enterococcal meningitis caused by Enterococcus casseliflavus. First case report. BMC Infect Dis 2005; 5 (01) 3 12 Gassas A, Kennedy J, Green G. , et al. Risk of ventriculoperitoneal shunt infections due to gastrostomy feeding tube insertion in pediatric patients with brain tumors. Pediatr Neurosurg 2006; 42 (02) 95-99
