Abstract：
Pathogen identification is essential for the treatment of bacterial meningitis. However, cerebrospinal fluid (CSF) culture tests are often negative when antimicrobial agents are administered before CSF is collected. Therefore, it is necessary to improve the culturing process for such samples. Here, we report a case of bacterial meningitis where the causative bacteria were detected by inoculating that patient\'s CSF samples into blood culture bottles. A 52-year-old man developed a fever and headache after undergoing transnasal transsphenoidal surgery for a nonfunctioning pituitary neuroendocrine tumor. He was suspected of having a wound infection, for which he was treated with cefozopran and vancomycin. A CSF test was also performed, owing to persistent fever, and bacterial meningitis was suspected. Although conventional CSF culture tests were negative, CSF cultures using blood culture bottles detected Enterococcus faecalis. The antimicrobial agents were therefore changed to ampicillin and gentamicin, after which the patient\'s meningitis improved. The blood culture bottles used contained adsorbed polymer beads with antimicrobial neutralizing properties, which likely contributed to the isolation of the bacteria. In addition to conventional cultures, ones done in blood culture bottles may be useful for diagnosing bacterial meningitis via CSF samples-particularly in cases where antimicrobial agents have already been administered.
摘要：
病原体鉴定对于细菌性脑膜炎的治疗至关重要。然而,当在收集CSF之前施用抗微生物剂时，脑脊液（CSF）培养试验通常是阴性的。因此,有必要改进此类样品的培养过程。这里,我们报道了一例细菌性脑膜炎，其中通过将患者的CSF样本接种到血培养瓶中检测到致病菌。一名52岁的男子在接受经鼻蝶手术治疗无功能的垂体神经内分泌肿瘤后出现发烧和头痛。他被怀疑有伤口感染,为此他接受了头孢唑兰和万古霉素治疗。还进行了CSF测试，由于持续发烧，怀疑是细菌性脑膜炎。尽管常规CSF培养试验呈阴性,使用血培养瓶检测到粪肠球菌的CSF培养。因此，抗菌剂改为氨苄青霉素和庆大霉素，之后患者的脑膜炎好转。使用的血液培养瓶含有具有抗菌中和特性的吸附聚合物珠，这可能有助于细菌的分离。除了传统文化，在血培养瓶中进行的方法可能有助于通过CSF样本诊断细菌性脑膜炎-特别是在已经施用了抗微生物剂的情况下.
