Editor—Antimicrobial resistance in enterococci, particularly E faecium, may greatly restrict the choice of treatment. We report the case of a neonate with vancomycin resistant E faecium(VRE) meningitis successfully treated with quinupristin/dalfopristin (a semisynthetic injectable streptogramin) and chloramphenicol.

The patient underwent repair of obstructed infradiaphragmatic total anomalous pulmonary venous drainage on the first day of life. Recovery was complicated by an episode of necrotising enterocolitis for which cefotaxime and metronidazole were given. At the age of 13 days abdominal signs had resolved but the patient was febrile. Over the next three days six blood cultures yielded E faecium resistant to vancomycin, amoxycillin, …