Document Detail


Post-neurosurgical multidrug-resistant Acinetobacter baumannii meningitis successfully treated with intrathecal colistin. A new case and a systematic review of the literature.
MedLine Citation:
PMID:  19892577     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Post-neurosurgical nosocomial meningitis has become an important subgroup of bacterial meningitis 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 craniofacial trauma, who developed a nosocomial meningitis due to MDR A. baumannii that was cured by intrathecal colistin. The case is contextualized among all the published cases of Acinetobacter meningitis treated with topical colistin found through a MEDLINE search of the literature. To date, including the present case, eight reported cases of Acinetobacter meningitis have been treated with colistin administered by an intrathecal route and 24 by an intraventricular route. The daily dose of colistin used ranged from 1.6 mg every 24 h to 20 mg every 24 h in adult patients. The median time necessary to obtain cerebrospinal fluid sterilization was 4.1 days, and treatment was always successful even if in two cases Acinetobacter meningitis relapsed. Toxicity probably or possibly related to the topical administration of colistin was noted in five out of the 32 patients.
CONCLUSIONS: Topical colistin can be an effective and safe treatment for MDR Acinetobacter meningitis.
Authors:
Antonio Cascio; Alfredo Conti; Luca Sinardi; Chiara Iaria; Filippo Flavio Angileri; Giovanna Stassi; Teresa David; Antonio Versaci; Maurizio Iaria; Antonio David
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Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2009-11-04
Journal Detail:
Title:  International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases     Volume:  14     ISSN:  1878-3511     ISO Abbreviation:  Int. J. Infect. Dis.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-15     Completed Date:  2010-09-27     Revised Date:  2013-07-15    
Medline Journal Info:
Nlm Unique ID:  9610933     Medline TA:  Int J Infect Dis     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e572-9     Citation Subset:  IM    
Copyright Information:
Copyright 2009. Published by Elsevier Ltd.
Affiliation:
Tropical and Parasitological Diseases Unit, Department of Human Pathology, University of Messina, Via Consolare Valeria n. 1, 98125 Messina, Italy. acascio@unime.it
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MeSH Terms
Descriptor/Qualifier:
Acinetobacter Infections / drug therapy,  microbiology
Acinetobacter baumannii / drug effects*
Adult
Anti-Bacterial Agents / administration & dosage*
Colistin / administration & dosage*
Craniocerebral Trauma / surgery*
Drug Resistance, Multiple, Bacterial*
Humans
Injections, Spinal
Male
Meningitis, Bacterial / drug therapy*,  microbiology
Postoperative Complications / drug therapy*,  microbiology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 1066-17-7/Colistin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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