Three cases of bacterial meningitis after spinal and epidural anesthesia.

During a 3-year period, three cases of bacterial meningitis developing after spinal or epidural anesthesia were observed at one hospital in Germany. The causative organisms were Streptococcus salivarius (2 cases) and Staphylococcus aureus (1 case). In the first two cases, contamination of the needle by oropharyngeal flora of the anesthesiological team was likely but remained unproven. In the third case, a nasal swab obtained from the operating anesthesiologist yielded a Staphylococcus aureus strain whose genotypic profile was identical to that of the patient's strain. Infection control procedures for spinal anesthesia are discussed.