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Meningitis Following Spinal Anesthesia: 6 Cases in 5 Years

Published online by Cambridge University Press:  02 January 2015

Lisa Rubin*
Affiliation:
Haifa District Health Office, Haifa, Israel School of Public Health, Faculty of Welfare and Health Sciences, University of Haifa, Haifa, Israel
Hannah Sprecher
Affiliation:
Microbiology Laboratory, Rambam Medical Center, Haifa, Israel
Ahmed Kabaha
Affiliation:
Haifa District Health Office, Haifa, Israel
Gabriel Weber
Affiliation:
Infectious Diseases Unit, Carmel Medical Center, Haifa, Israel Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
Nava Teitler
Affiliation:
HaEmek Medical Center, Afula, Israel
Shmuel Rishpon
Affiliation:
Haifa District Health Office, Haifa, Israel School of Public Health, Faculty of Welfare and Health Sciences, University of Haifa, Haifa, Israel
*
Deputy District Health Officer, Haifa District Health Office, Palyam 15 A, Haifa, Israel ([email protected])

Abstract

We describe 6 cases of meningitis after spinal anesthesia associated with a single anesthesiologist over the course of 5 years. The earliest case occurred in 2000, and the other 5 cases occurred over the course of 14 months in 2004-2005. The case identified in 2000 was culture-positive for Streptococcus salivarius. The other 5 cases were culture-negative for this organism but in 2 cases, the cerebrospinal fluid was found to be positive for bacterial DNA that was identified as belonging to S. salivarius by sequencing of the 16S rRNA gene. The association with a single anesthesiologist and a single hospital during a relatively short interval, however, lead us to believe that these occurrences are part of a series associated with possible violations of aseptic technique.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007 

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References

1. Videira, RLR, Ruiz-Neta, PP, Brandao Neto, M. Post spinal meningitis and asepsis. Acta Anaesthesiol Scand 2002;46:639646.Google Scholar
2. Moen, V, Dahlgren, N, Irestedt, L. Severe neurological complications after central neuraxial blockades in Sweden 1990-1999. Anesthesiology 2004;101:950959.Google Scholar
3. Baer, ET. Iatrogenic meningitis: the case for face masks. Clin Infect Dis 2000;31:519521.Google Scholar
4. Laurila, JJ, Kostamovaara, PA, Alahuhta, S. Streptococcus salivarius meningitis after spinal anesthesia. Anesthesiology 1998;89:15791580.Google Scholar
5. Newton, JA Jr, Lesnik, IK, Kennedy, CA. Streptococcus salivarius meningitis following spinal anesthesia. Clin Infect Dis 1994;18:840841.Google Scholar
6. Watanakunakorn, C, Stahl, C. Streptococcus salivarius meningitis following myelography. Infect Control Hosp Epidemiol 1992;13:7475.Google Scholar
7. Torres, E, Alba, D, Frank, A, Diez-Tejedor, E. Iatrogenic meningitis due to Streptococcus salivarius following a spinal tap. Clin Infect Dis 1993;17:525526.Google Scholar
8. Pandian, JD, Sarada, C, Radhakrishnan, W, Kishore, A. Iatrogenic meningitis after lumbar puncture—a preventable health hazard. J Hosp Infect 2004;56:119124.Google Scholar
9. Easley, RB, George, R, Connors, D, Tobias, JD. Aseptic meningitis after spinal anesthesia in an infant. Anesthesiology 2000;92:12001201.Google Scholar
10. Basic Local Alignment Search Tool (BLAST). Available at: http://www.ncbi.nlm.nih.gov/BLAST/. Accessed March 23, 2007.Google Scholar
11. Dejong, J, Barrs, ACM. Lumbar myelography followed by meningitis. Infect Control Hosp Epidemiol 1992;13:7475.Google Scholar
12. Schneeberger, PM, Janssen, M, Voss, A. Alpha-hemolytic streptococci: a major pathogen of iatrogenic meningitis following lumbar puncture. Case reports and a review of the literature. Infection 1996;24:2933.Google Scholar
13. Raedler, C. Bacterial contamination of needles used for spinal and epidural anesthesia. Br J Anaesth 1999;83:657658.Google Scholar
14. Kazor, CE, Mitchell, PM, Lee, AM, et al. Diversity of bacterial populations on the tongue dorsa of patients with halitosis and healthy patients. J Clin Microbiol 2003;41:558563.Google Scholar
15. Trautmann, M, Lepper, P, Schmitz, F-J. Three cases of bacterial meningitis after spinal and epidural anesthesia. Eur J Clin Microbiol Infect Dis 2002;21:4345.Google Scholar
16. Veringa, E, van Belkum, A, Schellekens, H. Iatrogenic meningitis by Streptococcus salivarius following lumbar puncture. J Hosp Infect 1995;29:316318.Google Scholar
17. Philips, BJ, Fergusson, S, Armstrong, P, Anderson, FM, Wildsmith, JAW. Surgical face masks are effective in reducing bacterial contamination caused by dispersal from the upper airway. Br J Anaesth 1992;69:407408.Google Scholar
18. McLure, HA, Talboys, CA, Yentis, SM, Azadian, BS. Surgical face masks and downward dispersal of bacteria. Anaesthesia 1998;53:624.Google Scholar
19. McLure, HA, Mannam, M, Talboys, CA, Azadian, BS, Yentis, SM. The effect of facial hair and sex on the dispersal of bacteria below a masked subject. Anaesthesia 2000;55:173.Google Scholar
20. Black, SR, Weinstein, RA. The case for face masks—Zorro or zero? Clin Infect Dis 2000;31:522523.Google Scholar
21. Guidelines for environmental infection control in health-care facilities. MMWR Recomm Rep 2003;52(RR10):142.Google Scholar
22. Rothman, RE, Majmudar, MD, Kelen, GD, et al. Detection of bacteremia in emergency department patients at risk for infective endocarditis using universal 16S rRNA primers in a decontaminated polymerase chain reaction assay. J Infect Dis 2002;186:16771681.Google Scholar