English

Abstract

Enterobacte r species are increasingly a cause of nosocomial meningitis among neurosurgery patients, but risk factors for these infections are not well defined. It was found that external cerebrospinal fluid (CSF) drainage devices, isolation of Enterobacter species from a non-CSF culture, prolonged administration of antimicrobial drugs before the diagnosis of meningitis that were inactive in vitro against Enterobacter species, immunosuppression and advanced age are also independent risk factors for Enterobacter Meningitis. Despite favourable treatment outcomes, EM is a serious infection associated with Enterobacter species colonization or infection at other surgical sites, with selective antimicrobial pressure, and with invasive CNS devices. The treatment is difficult because of inability of many of the antibiotics that are active against these bacteria to achieve adequate concentration in CSF. However third generation cephalosporins are active against gram negative bacilli and also achieved high concentration in CSF.