Vancomycin-Resistant Enterococcus faecium Meningitis Successfully Treated With Daptomycin in Combination With Doxycycline and Linezolid Case Report

摘要

Enterococcus species are uncommon pathogens in acute bacterial meningitis. Various antibiotics have been used with different outcomes, but optimal therapy has yet to be established owing to the bacteriostatic properties of most agents and the difficulty achieving therapeutic drug concentrations in the central nervous system. We present a case of vancomycin-resistant Enterococcus (VRE) meningitis treated with daptomycin in combination with doxycycline and linezolid and review the previously reported cases. Enterococcus is a common nosocomial pathogen associated with significant morbidity and mortality. Enterococci are intrinsically resistant to cephalosporins and possess the ability to acquire resistance through the exchange of plasmids. Vancomycin-resistant enterococci (VRE) first appeared in 1986 and since then have spread worldwide. The 2004 National Nosocomial Infections Surveillance System report indicated that 28.5% of enterococcal isolates in the ICU were VRE; this represents a 12% increase in resistance compared with rates for the period 1998 to 2002.