Letter to the Editor

Vancomycin-resistant Enterococcus faecium Meningitis Successfully Treated with Linezolid

Authors: Kelly N. Mizell, MD, J Elliot Carter, MD

Abstract

To the Editor:


Over the last two decades, vancomycin resistance in enterococci has become increasingly prevalent since first described by Leclercq et al in 1988.1 In the United States, the resistance is due to the widespread use of vancomycin with resultant colonization and infection, predominantly in ill and debilitated patients in the nosocomial setting. In Europe, avoparcin, a glycopeptide similar to vancomycin, has been used extensively in the agricultural industry, creating an animal reservoir for vancomycin-resistant enterococci (VRE) and causing widespread colonization of the healthy populace.2 Although the incidence of significant VRE infections has remained low in European countries, a spectrum of clinically significant infections have been documented in relation to VRE in the United States, including urinary tract infections, pneumonia, septicemia, endocarditis, and rarely, meningitis.

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References

1. Leclercq R, Derlot E, Duval J, et al. Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium. N Engl J Med 1988;319:157–161.
 
2. Bonten MJ, Willems R, Weinstein RA. Vancomycin-resistant enterococci: why are they here, and where do they come from? Lancet Infect Dis 2001;1:314–325.
 
3. Zanella RC, Valdetaro F, Lovgren M, et al. First confirmed case of a vancomycin-resistant Enterococcus faecium with vanA phenotype from Brazil: isolation from a meningitis case in Sao Paulo. Microb Drug Resist 1999 Summer;5:159–162.
 
4. Koc Y, Snydman DR, Schenkein DS, et al. Vancomycin-resistant enterococcal infections in bone marrow transplant recipients. Bone Marrow Transplant 1998;22:207–209.
 
5. Losonsky GA, Wolf A, Schwalbe RS, et al. Succesful treatment of meningitis due to multiply resistant Enterococcus faecium with a combination of intrathecal teicoplanin and intravenous antimicrobial agents. Clin Infect Dis 1994;19:163–165.
 
6. Williamson JC, Glazier SS, Peacock JE. Successful treatment of ventriculostomy-related meningitis caused by vancomycin-resistant enterococcus with intravenous and intraventricular quinupristin/dalfopristin. Clin Neurol Neurosurg 2002;104:54–56.
 
7. Shaikh ZHA, Peloquin CA, Ericsson CD. Successful treatment of vancomycin-resistant Enterococcus faecium meningitis with linezolid: case report and literature review. Scand J Infect Dis 2001;33:375–379.
 
8. Pai M, Rodvold KA, Schreckenberger PC, et al. Risk factors associated with the development of infection with linezolid- and vancomycin-resistant Enterococcus faecium. Clin Infect Dis 2002;35:1269–1272.