Search

Background and Objective: In recent years, meningitis caused by methicillin-resistant S. aureus has increased. This study was undertaken to compare the clinical characteristics and prognosis of methicillin-resistant S. aureus (MRSA) postneurosurgical meningitis and methicillin-sensible S. aureus (MSSA) postneurosurgical meningitis., Patients and Methods: Twenty-five episodes of postneurosurgical meningitis due to S. aureus (13 methicillin-resistant strains) seen during a ten-year period were retrospectively reviewed., Results: Most common underlying diseases were: intracerebral hemorrhage (50% of MRSA patients and 46% of MSSA patients) and neoplasm (53% of MRSA patients and 33% of MSSA patients). Eleven patients (6 of them with MRSA infection) had received antibiotic treatment previously. Thirteen patients were carriers of intraventricular catheters (8 with MRSA infection), 5 wore a ventriculoperitoneal shunt (4 with infections by MSSA), 5 cases had a CSF leakage (4 with infections by MRSA), and one patient with infection by MSSA wore an epidural catheter. Fifteen patients were cured (7 with MRSA infection), and 8 died due to the infection (27% with MSSA infection and 38% with MRSA infection)., Conclusions: The prognosis of postneurosurgical meningitis by S. aureus does not depend on the presence of resistance to methicillin. Nowadays, the intravenous administration of vancomycin is the treatment of choice in MRSA meningitis.

Pseudomonas infections continue to be an important problem in the hospital environment. Serious infections are always invariably associated with severe underlying conditions or with diminished host resistance. The increasingly resistance of strains and hospital epidemics favour the organism prevalence. During 1978, Pseudomonas aeruginosa was isolated in 154 cultures from a variety of biological samples in the hospital. Tests of biochemical identification, serological typing, and typing by pyocine production were carried out. Susceptibility to aminoglycosides and beta-lactamic antibiotics was also tested. Serological study demonstrated a higher incidence of 4 and 11 serotypes; 69.4 percent corresponded to type I when typing by pyocine production was carried out. No relationship between serotypes and pyocine-types has been found. Ticarcillin showed a greater activity than carbenicillin (minimal inhibitory concentration less than or equal to 16 micrograms/ml). Amikacin, tobramicin, sisomicin and gentamicin inhibited 83.7 percent, 73.6 percent, 70.7 percent and 69.4 percent of the isolated strains, respectively.