Post-neurosurgical multidrug-resistant Acinetobacter baumannii meningitis successfully treated with intrathecal colistin. A new case and a systematic review of the literature

Antonio Cascio, Maurizio Iaria, Teresa David, Giovanna Stassi, Antonio Versaci, Filippo Flavio Angileri, Antonio Versaci, Antonio Cascio, Alfredo Conti, Antonio David, Chiara Iaria, Luca Sinardi

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64 Citazioni (Scopus)

Abstract

Introduction: Post-neurosurgical nosocomial meningitis has become an important subgroup of bacterialmeningitis in the hospital setting. The increase in meningitis caused by multidrug-resistant (MDR)Acinetobacter baumannii has resulted in a significant reduction in available treatment options.Case report and literature review: We report the case of a 36-year-old man with a complex craniofacialtrauma, who developed a nosocomial meningitis due to MDR A. baumannii that was cured by intrathecalcolistin. The case is contextualized among all the published cases of Acinetobacter meningitis treatedwith topical colistin found through a MEDLINE search of the literature. To date, including the presentcase, eight reported cases of Acinetobacter meningitis have been treated with colistin administered by anintrathecal route and 24 by an intraventricular route. The daily dose of colistin used ranged from 1.6 mgevery 24 h to 20 mg every 24 h in adult patients. Themedian time necessary to obtain cerebrospinal fluidsterilization was 4.1 days, and treatment was always successful even if in two cases Acinetobactermeningitis relapsed. Toxicity probably or possibly related to the topical administration of colistin wasnoted in five out of the 32 patients.Conclusions: Topical colistin can be an effective and safe treatment for MDR Acinetobacter meningitis.
Lingua originaleEnglish
pagine (da-a)572-579
Numero di pagine8
RivistaInternational Journal of Infectious Diseases
Volume14
Stato di pubblicazionePublished - 2010

All Science Journal Classification (ASJC) codes

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