Acinetobacter species meningitis in children: a case series from Karachi, Pakistan.
J Infect Dev Ctries
; 5(11): 809-14, 2011 Nov 15.
Article
em En
| MEDLINE
| ID: mdl-22112736
ABSTRACT
INTRODUCTION:
Multidrug-resistant strains of Acinetobacter pose a serious therapeutic dilemma in hospital practice, particularly when they cause meningitis, as the few antimicrobial agents to which these isolates are susceptible have poor central nervous system (CNS) penetration.METHODOLOGY:
We retrospectively reviewed the clinical course and outcome of eight consecutive cases of meningitis due to Acinetobacter spp. in children ages 15 years or less, seen in a tertiary care medical center in Karachi, Pakistan.RESULTS:
Of the eight cases of Acinetobacter meningitis, isolates from five patients were pan-resistant, and two were multidrug-resistant. A neurosurgical procedure was performed in five of eight patients followed by external ventricular drain insertion prior to the development of infection. Seven received intravenous (IV) polymyxin (mean; 12.8 days), while 5/8 also received intrathecal (IT) polymyxin (mean; 12.0 days). The mean length of hospitalization was 38.7 ± 19 days. All patients achieved cerebrospinal fluid (CSF) culture negativity by the end of treatment (mean; 5.4 days). Two patients died one with pan-resistant Acinetobacter, and the second with a multi-drug resistant isolate.CONCLUSION:
Post-neurosurgical multidrug-resistant and pan-resistant Acinetobacter meningitis can be successfully treated if appropriate antimicrobial therapy is instituted early. The role of IT polymyxin B administration alone versus combination therapy (IV and IT) needs further study.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Acinetobacter
/
Infecções por Acinetobacter
/
Meningites Bacterianas
Tipo de estudo:
Observational_studies
Limite:
Child
/
Female
/
Humans
/
Infant
/
Male
/
Newborn
País/Região como assunto:
Asia
Idioma:
En
Revista:
J Infect Dev Ctries
Assunto da revista:
DOENCAS TRANSMISSIVEIS
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Paquistão
País de publicação:
IT
/
ITALIA
/
ITALY
/
ITÁLIA