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Healthcare-Associated Bacterial Meningitis

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Abstract

Healthcare-associated bacterial meningitis may occur after neurosurgical procedures, head trauma, and following placement of external or internal ventricular catheters. The likely microorganisms that cause meningitis in this setting (ie, staphylococci and gram-negative bacilli) are different from those that cause meningitis in the community setting. Any clinical suspicion of healthcare-associated bacterial meningitis should prompt a diagnostic evaluation (neuroimaging and cerebrospinal fluid analysis) and appropriate management. Empiric antimicrobial therapy should be directed toward the likely infecting pathogen; based upon clinical response, intraventricular administration of specific agents may be required. With the emergence of resistant gram-negative bacilli (especially Acinetobacter baumannii) that may cause healthcare-associated meningitis, empiric therapy with a carbapenem, with or without an aminoglycoside administered by the intraventricular or intrathecal route, is recommended; colistin (given intravenously and/or intraventricularly) can be used if the organism is subsequently found to be resistant to carbapenems.

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Disclosure

Conflicts of interest: S. Laxmi: none; A.R. Tunkel: has been a consultant for the US Food and Drug Administration, has received honoraria from the American College of Physicians, and receives royalties from Up-to-Date.

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  1. Department of Medicine, Monmouth Medical Center, 300 Second Avenue, Long Branch, NJ, 07740, USA

    Sheethal Laxmi & Allan R. Tunkel

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  1. Sheethal Laxmi
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  2. Allan R. Tunkel
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Correspondence to Allan R. Tunkel.

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Laxmi, S., Tunkel, A.R. Healthcare-Associated Bacterial Meningitis. Curr Infect Dis Rep 13, 367–373 (2011). https://doi.org/10.1007/s11908-011-0190-z

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