Praharaj, ISujatha, SParija, S CGopalakrishnan, M S2012-12-182012-12-182012-04Praharaj I, Sujatha S, Parija S C, Gopalakrishnan M S. Fatal meningitis caused by vancomycin-resistant enterococci: Report of two cases from south India. Indian Journal of Medical Microbiology. 2012 Apr-June; 30(2): 242-245.http://imsear.searo.who.int/handle/123456789/143957Vancomycin-resistant enterococci rarely cause meningitis and present a therapeutic challenge. Antimicrobial susceptibility testing was done for strains of Enterococcus species isolated from CSF samples of patients with meningitis by phenotypic methods. Multiplex polymerase chain reaction was performed to determine the genetic basis of vancomycin resistance of such isolates. We report here two cases of enterococcal meningitis caused by vancomycin-resistant Enterococcus species. One of the isolates was identified as Enterococcus faecalis and the other as Enterococcus gallinarum. We also report the simultaneous presence of vanC1 and vanA resistance genes in the strain of E. gallinarum. To the best of our knowledge, this is the first report of vanA resistance gene in an isolate of E. gallinarum from the Indian subcontinent. This is also the first Indian report of vancomycin-resistant Enterococcus causing meningitis.enEnterococcusmultiplex PCRmeningitisresistancevancomycinAgedAnti-Bacterial Agents --pharmacologyCerebrospinal Fluid --microbiologyDNA, Bacterial --geneticsEnterococcus --classificationEnterococcus --drug effectsEnterococcus --isolation & purificationFatal OutcomeFemaleGenes, BacterialGram-Positive Bacterial Infections --diagnosisGram-Positive Bacterial Infections --mortalityGram-Positive Bacterial Infections --pathologyHumansIndiaMaleMeningitis, Bacterial --diagnosisMeningitis, Bacterial --mortalityMeningitis, Bacterial --pathologyMicrobial Sensitivity TestsMiddle AgedMultiplex Polymerase Chain ReactionVancomycin ResistanceArticle