• Ayşe Şahin and Nazan Dalgic.
• Department of Pediatric Infectious Diseases, University of Health Sciences, Sisli Hamidiye Etfal Research and Education Hospital, Istanbul, Turkey. Electronic address: ayseturgutsahin@gmail.com.
• World Neurosurg. 2019 Oct 1; 130: 470-473.

BackgroundVentriculoperitoneal (VP) shunt infection, which is 1 of the most important complications of VP shunt is observed at a rate of 4%-17%. Staphylococcus epidermidis is the most common causative agent. Vancomycin-resistant Enterococcus (VRE) is an increasingly common nosocomial pathogen that rarely causes central nervous system infections globally. Current treatment options that have shown appreciable activity against various VRE infections include daptomycin, linezolid, inquinupristin/dalfopristin, and tigecycline. Daptomycin has a particular mode of action and a potent bactericidal activity, making it a useful addition to the clinician's antibiotic collection. Global surveillance data indicate <1.0% rates of daptomycin resistance in enterococci.Case DescriptionHere, we describe, to the best of our knowledge, the first case of successful intraventricular plus intravenous use of tigecycline to treat VP shunt infections caused by daptomycin resistant VRE faecium.ConclusionTigecycline is a life-saving option in the treatment of resistant nosocomial infections but it has not yet been approved for use and there are not enough data in terms of dose and side effects associated with its use in children.Copyright © 2019 Elsevier Inc. All rights reserved.

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