Successful Management of Pan-Resistant Acinetobacter baumannii Meningitis without Intrathecal or Intraventricular Antibiotic Therapy in a Neonate

다국어 초록 (Multilingual Abstract)

Acinetobacter baumannii is one of the most important etiologies of nosocomial infections in recent years mainly because of increasing in frequency of multidrug and pan-resistant pathogens. Meningitis caused by this organism is a dilemma; because polymyxins are the only effective antibiotics against pan-resistant serotypes, but have poor penetration via blood brain barrier; however, it has still remained uncertain whether the intravenous therapy with these agents is an effective treatment with the sufficient concentration of the drug in the cerebrospinal fluid. Herein, we report a neonate who suffered from pan-resistant A. baumannii nosocomial meningitis successfully treated with intravenous colistin combined with meropenem and rifampin. It seems that intravenous colistin at least in combination with rifampin and meropenem might be considered as an option to try in patients in whom daily intrathecal injection or insertion of intraventricular device is not possible.

참고문헌 (Reference)

1 Bukhary Z, "Treatment of nosocomial meningitis due to a multidrug resistant Acinetobacter baumannii with intraventricular colistin" 26 : 656-658, 2005

2 Fishbain J, "Treatment of Acinetobacter infections" 51 : 79-84, 2010

3 Hu J, "Systematic review of invasive Acinetobacter infections in children" 21 : 83-88, 2010

4 Fernandez-Viladrich P, "Successful treatment of ventriculitis due to carbapenem-resistant Acinetobacter baumannii with intraventricular colistin sulfomethate sodium" 28 : 916-917, 1999

5 Jiménez-Mejías ME, "Successful treatment of multidrug-resistant Acinetobacter baumannii meningitis with intravenous colistin sulfomethate sodium" 19 : 970-971, 2000

6 Katragkou A, "Successful treatment of multidrug-resistant Acinetobacter baumannii central nervous system infections with colistin" 43 : 4916-4917, 2005

7 Benifla M, "Successful treatment of Acinetobacter meningitis with intrathecal polymyxin E" 54 : 290-292, 2004

8 Cascio A, "Postneurosurgical multidrug-resistant Acinetobacter baumannii meningitis successfully treated with intrathecal colistin. A new case and a systematic review of the literature" 14 : e572-e579, 2010

9 Mehar V, "Neonatal ventriculitis with multi drug resistant Acinetobacter baumanii: a case report and review of literature" 2 : 1-3, 2012

10 Tuon FF, "Mortality rate in patients with nosocomial Acinetobacter meningitis from a Brazilian hospital" 14 : 437-440, 2010

11 Kim BN, "Management of meningitis due to antibiotic-resistant Acinetobacter species" 9 : 245-255, 2009

12 Piparsania S, "Intraventricular polymyxin B for the treatment of neonatal meningo-ventriculitis caused by multi-resistant Acinetobacter baumannii--case report and review of literature" 54 : 548-554, 2012

13 Levin AS, "Intravenous colistin as therapy for nosocomial infections caused by multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii." 28 : 1008-1011, 1999

14 Garcia C, "Feigin and Cherry's textbook of pediatric infectious diseases" Sauners 3182-3241, 2014

15 Ng J, "Cure of multiresistant Acinetobacter baumannii central nervous system infections with intraventricular or intrathecal colistin: case series and literature review" 58 : 1078-1081, 2006

16 Jiménez-Mejías ME, "Cerebrospinal fluid penetration and pharmacokinetic/pharmacodynamic parameters of intravenously administered colistin in a case of multidrug-resistant Acinetobacter baumannii meningitis" 21 : 212-214, 2002

17 Fulnecky EJ, Wright D, Scheld WM, Kanawati L, Shoham S, "Amikacin and colistin for treatment of Acinetobacter baumannii meningitis" 51 : e249-e251, 2005

18 Saleem AF, "Acinetobacter species meningitis in children: a case series from Karachi, Pakistan" 5 : 809-814, 2011

19 Lowman W, "A case of community-acquired Acinetobacter baumannii meningitis - has the threat moved beyond the hospital?" 57 : 676-678, 2008