STAPHYLOCOCCUS-AUREUS MENINGITIS IN NEUROSURGERY ADULT PATIENTS - RETROSPECTIVE CLINICAL AND MICROBIOLOGIC ANALYSIS

We reviewed 12 cases of Staphylococcus aureus meningitis occurring ove r a 5-year period in five neurosurgery divisions at the Policlinico Um berto I. Six patients had an intraventricular shunt, five had cranioto my, and one had spinal surgery. All patients had one or more underlyin g causes other than surgery that might have predisposed to infection. Clinical presentation and cerebrospinal fluid (CSF) laboratory finding s did not distinguish this form of meningitis from other acute bacteri al meningitides. Gram stain of centrifuged CSF showed gram-positive co cci in 83% of cases. Blood cultures were positive in 25% of cases. Ove rall mortality was 50%. Eight CSF isolates were simultaneously resista nt to oxacillin and rifampicin. Six of 10 patients treated with a glyc opeptide were cured or improved. The remaining two patients with an ox acillin-susceptible S. aureus infection were cured: one was treated wi th cefamandole, the other one with ciprofloxacin and rifampicin.