Nosocomial Meningitis Caused by Acinetobacter baumannii : Risk Factors and Their Impact on Patient Outcomes and Treatments

• Published in: Future microbiology Vol. 7; no. 6; pp. 787 - 793
• Main Authors: Yang, Minjie, Hu, Zupeng, Hu, Fupin
• Format: Journal Article
• Language: English
• Published: England Future Medicine Ltd 01.06.2012
• Subjects: Acinetobacter; Acinetobacter baumannii; Acinetobacter baumannii - isolation & purification; Acinetobacter Infections - epidemiology; Acinetobacter Infections - microbiology; Adolescent; Adult; Aged; Antibiotics; Antimicrobial agents; Bacterial infections; Blood; Brain; Carbapenems; Causes of; Child; Clinical trials; Consciousness; Cross Infection - epidemiology; Cross Infection - microbiology; Disease transmission; Drug resistance; Drug resistance in microorganisms; Drug therapy; Family medical history; Female; Fever; Gentamicin; Health aspects; Hospitals; Human subjects; Humans; Infection; Intravenous administration; Male; Meningitis; Meningitis, Bacterial - epidemiology; Meningitis, Bacterial - microbiology; Middle Aged; Mortality; Neurosurgery; Patient outcomes; Retrospective Studies; Risk Factors; Shunts; Survival; Treatment Outcome; Young Adult; China
• ISSN: 1746-0913; 1746-0921; 1746-0921
• DOI: 10.2217/fmb.12.42

To increase our understanding of the clinical characteristics of nosocomial meningitis caused by Acinetobacter baumannii and provide a basis for improving its treatment. A retrospective analysis was undertaken of 35 cases of A. baumannii meningitis to identify risk factors and their impact on patient outcomes (treatment effectiveness and survival rates). Most patients were from a neurosurgery ward and had multidrug-resistant Acinetobacter infections. Brain neoplasms were the most frequent underlying disease. In total, 97.1% of patients had undergone surgical procedures within the previous month, mostly craniotomies with shunts. For treatment, intravenous carbapenems alone or combined with other antibiotics were used in 28 patients (80.0%), and were effective in 13 of these patients (46.4%). In addition to intravenous antibiotics, intrathecal therapy (gentamicin) or removal of all neurosurgical hardware was used in 18 patients (51.4%). In view of the lack of effective therapeutic options for the treatment of A. baumannii meningitis at the present time, there is a need for new therapies, well-controlled clinical trials of existing antimicrobial regimens and a greater emphasis on preventing nosocomial transmission of multidrug-resistant Acinetobacter strains.