Nosocomial Escherichia coli meningitis in adults: Report of four cases and literature review.

We report four cases of nosocomial E. coli meningitis, in male patients with accidental and neurosurgical trauma. The interval between accidents/neurosurgical procedures and the onset of meningitis was 2-15 days (mean 6.25 days). The most consistent clinical features were fever and deterioration of consciousness level. Emergence of extended spectrum beta lactamase E. coli strains had been observed in two (50%) of our cases and the mean duration of antimicrobial treatment was 16.5 days (range: 6-24 days). Two of the four patients (50%) died in the hospital.