Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-05T19:43:40.037Z Has data issue: false hasContentIssue false
  • English
  • Français

Meningitis Following Spinal Anesthesia: 6 Cases in 5 Years

Published online by Cambridge University Press:  02 January 2015

Lisa Rubin ,
Hannah Sprecher ,
Ahmed Kabaha ,
Gabriel Weber ,
Nava Teitler  and
Shmuel Rishpon
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])
Get access Rights & Permissions [Opens in a new window]

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
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 10 , October 2007 , pp. 1187 - 1190
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Videira, RLR, Ruiz-Neta, PP, Brandao Neto, M. Post spinal meningitis and asepsis. Acta Anaesthesiol Scand 2002;46:639–646.Google Scholar
2. Moen, V, Dahlgren, N, Irestedt, L. Severe neurological complications after central neuraxial blockades in Sweden 1990-1999. Anesthesiology 2004;101:950–959.Google Scholar
3. Baer, ET. Iatrogenic meningitis: the case for face masks. Clin Infect Dis 2000;31:519–521.Google Scholar
4. Laurila, JJ, Kostamovaara, PA, Alahuhta, S. Streptococcus salivarius meningitis after spinal anesthesia. Anesthesiology 1998;89:1579–1580.Google Scholar
5. Newton, JA Jr, Lesnik, IK, Kennedy, CA. Streptococcus salivarius meningitis following spinal anesthesia. Clin Infect Dis 1994;18:840–841.Google Scholar
6. Watanakunakorn, C, Stahl, C. Streptococcus salivarius meningitis following myelography. Infect Control Hosp Epidemiol 1992;13:74–75.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;17:525–526.Google Scholar
8. Pandian, JD, Sarada, C, Radhakrishnan, W, Kishore, A. Iatrogenic meningitis after lumbar puncture—a preventable health hazard. J Hosp Infect 2004;56:119–124.Google Scholar
9. Easley, RB, George, R, Connors, D, Tobias, JD. Aseptic meningitis after spinal anesthesia in an infant. Anesthesiology 2000;92:1200–1201.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;13:74–75.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;24:29–33.Google Scholar
13. Raedler, C. Bacterial contamination of needles used for spinal and epidural anesthesia. Br J Anaesth 1999;83:657–658.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;41:558–563.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;21:43–45.Google Scholar
16. Veringa, E, van Belkum, A, Schellekens, H. Iatrogenic meningitis by Streptococcus salivarius following lumbar puncture. J Hosp Infect 1995;29:316–318.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;69:407–408.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;31:522–523.Google Scholar
21. Guidelines for environmental infection control in health-care facilities. MMWR Recomm Rep 2003;52(RR10):1–42.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;186:1677–1681.Google Scholar