Intra-cerebrospinal fluid antibiotics to treat central nervous system infections: A review and update

Mrowczynski, Oliver; Langan, Sara; Rizk, Elias

doi:10.1016/j.clineuro.2018.05.007

Cited by 21 publications

(19 citation statements)

References 183 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hence, the intrathecal (ITH) or intraventricular (IVT) administration of antibiotics had been performed in recent years [34][35][36][37]. Whereas, ITH and IVT antibiotic therapy has not been standardized [2]. Further work is needed to explore the antimicrobial therapy through ITH/IVT approach, this might signi cantly improve the outcomes of patients with CNS infections.…”

Section: Discussionmentioning

confidence: 99%

“…Epidemiology, pathogens distribution, antibiotic susceptibility and the risk factors for mortality of patients with central nervous system infections: a retrospective study from 2012 to 2019 in a teaching hospital in China Background Central nervous system (CNS) infections include meningitis, encephalitis, and brain abscesses, can be complications following neurosurgical operations or occur spontaneously [1,2]. CNS infections cause signi cant mortality worldwide, resulting in a poor prognosis with prolonged length of hospital stay and increasing the total cost of illness [1][2][3][4][5]. The pathogens causing such infections include bacteria, viruses, fungi and parasites, and it is reported that there are more than 100 pathogens that cause CNS infections [5].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Epidemiology, pathogens distribution, antibiotic susceptibility and the risk factors for mortality of patients with central nervous system infections: a retrospective study from 2012 to 2019 in a teaching hospital in China

Zhang

Song

Kang

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Central nervous system (CNS) infections are relatively rare but associated with high mortality worldwide. Empirical antimicrobial therapy is crucial for the prognosis of patients with CNS infections, which should be based on the knowledge of pathogens distribution and antibiotic sensitivities. China is a vast country, and the pathogens distribution varies nationwide. The aim of this study is to investigate the features of pathogens in patients with CNS infections in north China and we tried to evaluate the risk factors for mortality.Methods: We retrospectively analyzed the patients with positive cerebrospinal fluid (CSF) culture in a teaching hospital between January 2012 and December 2019. The following information were collected: demographic characteristics, laboratory data, causative organisms and antimicrobial susceptibility results. Univariate analysis and binary logistic regression analysis were performed to identify the risk factors for mortality.Results: In this eight-year retrospective study, a total of 72 patients were diagnosed with CNS infections and 86 isolates were identified. Among all the microorganisms detected, Gram-positive strains consisted of 59.3%, Gram-negative bacteria of 30.2% and fungi of 10.5%. The predominant Gram-positive isolate was coagulase-negative staphylococci. Acinetobacter baumannii, Escherichia coli and Klebsiella were the common Gram-negative strains. Compared to 2012-2015 years, the proportion of Gram-negative bacteria increased markedly during 2016-2019 years. Vancomycin, teicoplanin and linezolid were still 100% sensitive to Gram-positive bacteria. For the multidrug-resistant Gram-negative bacteria, only tigecycline was the 100% sensitive antibiotics. The mortality of the 72 patients was 30.6%. In the multivariate analysis, age >50 years, combined pulmonary infection and CSF glucose < normal value were associated with poor prognosis. Conclusions: CNS infections cause high mortality worldwide. Although Gram-positive bacteria are still the primary pathogen of CNS infections, Gram-negative bacteria had increased in recent years and should be considered in the choice of empirical antibiotic treatment. Special attention should be given to older patients and those combined pulmonary infection and with low CSF glucose level.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Epidemiology, pathogens distribution, antibiotic susceptibility and the risk factors for mortality of patients with central nervous system infections: a retrospective study from 2012 to 2019 in a teaching hospital in China

Zhang

Song

Kang

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…The use of intrathecal/intraventricular antimicrobials in this setting has not been well studied. A review of the existing literature reveals no standard protocol for the administration of intraventricular antimicrobials in the setting of CNS infections [10]. The risk reward profile focuses on the advantages of higher doses of antimicrobials in the CSF than can cross the blood brain barrier alone versus the increased risk of toxicity.…”

Section: Discussionmentioning

confidence: 99%

A case of Listeria monocytogenes meningitis complicated by Hydrocephalus and Intraventricular hemorrhage: A review of treatment options and outcomes

Gerstein

Gautam-Goyal

Goyal

2020

IDCases

View full text Add to dashboard Cite

A B S T R A C TListeria monocytogenes is a gram-positive bacillus known to cause various human infections including central nervous system infections. The most common central nervous system manifestations are meningitis and rhomboencephalitis, however rare complications including hydrocephalus and intracerebral hemorrhage can occur and are associated with increased mortality and incidence of lasting neurologic sequelae. The mortality ranges from 17 % to greater than 30 % in patients with neurological involvement [1-3]. Various case reports have studied the differing treatment approaches and outcomes of patients who experienced these complications, and there is still no consensus on optimal treatment approaches. In this paper, we report a case of Listeria meningitis complicated by both acute hydrocephalus and intracerebral hemorrhage and analyze the factors that led to a favorable outcome by reviewing the existing literature.

show abstract

“…Common pathogens include Klebsiella species, Pseudomonas species, Acinetobacter baumannii, and Escherichia coli. 33,34 Third-and fourth-generation cephalosporins are common first-line empiric agents, though carbapenems can be considered as well. 13 Resistant organisms may require the use of aminoglycosides, polymyxin B, or colistin via intravenous or intrathecal route.…”

Section: Gram-negative Bacillimentioning

confidence: 99%

“…13 Resistant organisms may require the use of aminoglycosides, polymyxin B, or colistin via intravenous or intrathecal route. 13,34,35 The use of intrathecal or intraventricular antibiotics is an important option to consider as even some of the most commonly used intravenous agents have poor blood-brain barrier penetrance.…”

Section: Gram-negative Bacillimentioning

confidence: 99%

Pharmacologic Treatment of Meningitis and Encephalitis in Adult Patients

Treister

Koerner

2019

Journal of Neuroanaesthesiology and Critical Care

View full text Add to dashboard Cite

Meningitis and encephalitis are two inflammatory, often infectious, disorders of the meninges and the central nervous system. Both are associated with significant morbidity and mortality, and require early and aggressive targeted treatment. This article reviews pharmacologic treatment strategies for infectious meningitis and encephalitis, using the latest available research and guidelines. It provides an overview of empiric antimicrobial treatment approaches for a variety of organisms, including a discussion of trends in antibiotic resistance where applicable. Key steps in diagnosis and general management are briefly reviewed.

show abstract

Intra-cerebrospinal fluid antibiotics to treat central nervous system infections: A review and update

Cited by 21 publications

References 183 publications

Epidemiology, pathogens distribution, antibiotic susceptibility and the risk factors for mortality of patients with central nervous system infections: a retrospective study from 2012 to 2019 in a teaching hospital in China

Epidemiology, pathogens distribution, antibiotic susceptibility and the risk factors for mortality of patients with central nervous system infections: a retrospective study from 2012 to 2019 in a teaching hospital in China

A case of Listeria monocytogenes meningitis complicated by Hydrocephalus and Intraventricular hemorrhage: A review of treatment options and outcomes

Pharmacologic Treatment of Meningitis and Encephalitis in Adult Patients

Contact Info

Product

Resources

About