2020 Volume 56 Issue 2 Pages 335-342
Enterobacter cloacae, a gram-negative bacillus, is a member of the normal gut microbiota; however, it is often highly virulent in neonates. Notably, neurological sequelae of meningitis may occur despite the administration of systemic antibiotics. We describe a female neonate weighing 2,309 g born at 33 weeks and 4 days of gestation who developed E. cloacae meningitis and ventriculitis after undergoing surgery for jejunal atresia. She developed severe cerebral necrosis despite treatment with high-dose carbapenem. We speculated that bacterial translocation of E. cloacae secondary to surgical injury caused meningitis and ventriculitis. E. cloacae can rapidly colonize the gut in neonates soon after birth; therefore, early identification of this highly pathogenic organism is important to initiate prompt and optimal infection control measures, particularly in neonates undergoing gastrointestinal surgery.
