Acinetobacter baumannii meningitis in post-neurosurgical patients: clinical outcome and impact of carbapenem resistance

Metan, Gökhan; Alp, Emine; Aygen, Bilgehan; Sümerkan, Bülent

doi:10.1093/jac/dkm181

Cited by 62 publications

(43 citation statements)

References 8 publications

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“…Mortality rates ranging from 30%-70% have been previously reported and are generally higher in developing countries. 4,5,7,8 Studies assessing the mortality rate associated with meningitis have confi rmed higher mortality rates associated with Acinetobacter as compared to other Gramnegative bacilli. 4,9 Polymyxins penetrate the cerebrospinal fl uid and produce sustained bactericidal concentrations.…”

Section: Discussionmentioning

confidence: 99%

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Mortality rate in patients with nosocomial Acinetobacter meningitis from a Brazilian hospital

Tuon¹,

Penteado-Filho²,

Amarante³

et al. 2010

Braz J Infect Dis

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Background:The mortality rate due to Acinetobacter baumannii nosocomial meningitis (ANM) is high. Objective: The aim of this study was to evaluate the factors that have infl uence over the outcomes in ANM patients. Methods: A retrospective analysis of 22 cases of ANM was conducted in a hospital with high incidence of multidrug resistance. Results: The mean age of patients was 43 years (21 to 91) and 54.5% were male. All ANM cases occurred within 60 days of admission and the mean duration of illness was of 18.2 days. All cases were associated with previous neurosurgical procedures: elective surgery (27.2%), external shunt (54.4%) and emergency surgery due to trauma (18.1%). Imipenem resistance was observed in 40.9% of cases, but ampicillin/sulbactam resistance was lower (27.2%). The mortality rate of ANM patients was of 72.7%. The only risk factor associated with mortality was inappropriate therapy within fi ve days after CSF collection. All patients who survived the meningitis episode had received appropriate therapy, in contrast to only 69.2% of those who did not survive (OR = 5.15; IC = 0.45-54.01). Conclusions: The high mortality rate observed in our study suggests the need for aggressive empirical treatment with addition of drugs, including intrathecal therapy, where multi-resistant A. baumannii is endemic.

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Section: Discussionmentioning

confidence: 99%

“…4 In developing countries, it can reach up to 70%. 5 There have been no randomized controlled studies conducted to evaluate different treatments for Acinetobacter meningitis. The current treatment regimen is based on case reports and pharmacological data.…”

Section: Introductionmentioning

confidence: 99%

Mortality rate in patients with nosocomial Acinetobacter meningitis from a Brazilian hospital

Tuon¹,

Penteado-Filho²,

Amarante³

et al. 2010

Braz J Infect Dis

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show abstract

“…The organism's ability to survive under a wide range of environmental conditions and to persist for extended periods of time on surfaces make it a frequent cause of outbreaks of infection and an endemic, health care-associated pathogen [31,32]. In many studies Acinetobacter baumannii has been reported as a cause of meningitis as hospital acquired infection or acquired after neurosurgical procedures [33][34][35][36][37][38].…”

Section: Gram Negative Acute Bacterial Meningitis An Emerging Entity mentioning

confidence: 99%

Gram Negative Acute Bacterial Meningitis an Emerging Entity in a Tertiary Care Centre, New Delhi

Kasana¹

2016

JBMOA

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“…Combined therapy for multi-drug-resistant (MDR) Acinetobacter baumannii was hypothesized as beneficial despite the lack of evidence (Metan et al, 2007). MDR Acinetobacter has been classified as multi-drug resistant, extensively drug resistant (XDR) and pan-drug resistant (PDR).…”

Section: Introductionmentioning

confidence: 99%

Combined therapy for multi-drug-resistant Acinetobacter baumannii infection – is there evidence outside the laboratory?

Tuon

Rocha

Merlini

2015

Journal of Medical Microbiology

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Acinetobacter baumannii meningitis in post-neurosurgical patients: clinical outcome and impact of carbapenem resistance

Cited by 62 publications

References 8 publications

Mortality rate in patients with nosocomial Acinetobacter meningitis from a Brazilian hospital

Mortality rate in patients with nosocomial Acinetobacter meningitis from a Brazilian hospital

Gram Negative Acute Bacterial Meningitis an Emerging Entity in a Tertiary Care Centre, New Delhi

Combined therapy for multi-drug-resistant Acinetobacter baumannii infection – is there evidence outside the laboratory?

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