ABSTRACT
There are three antimicrobial-resistant bacterial infections that are a threat to neurosurgical and neurological patients: penicillin and cephalosporin-resistant Streptococcus pneumoniae, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci. Streptococcus pneumoniae infections are typically community-acquired, whereas MRSA and vancomycinresistant enterococci occur in patients who have undergone a neurosurgical procedure, especially those involving an intracranial device such as a ventriculostomy, have had a prolonged hospitalization, or a number of courses of antimicrobial therapy. The emergence of antimicrobial-resistant bacterial infections has changed the recommendations for the empiric therapy of communityand hospital-acquired meningitis and the management of the postoperative neurosurgical patient.
