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Implications of postneurosurgical meningitis caused by carbapenem-resistant Acinetobacter baumannii

  • Original Article
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Journal of Infection and Chemotherapy

Abstract

Acinetobacter baumannii is an important cause of postneurosurgical meningitis. The emergence of carbapenem-resistant strains in this setting has caused a therapeutic challenge. We investigated the clinical implications of postneurosurgical meningitis caused by carbapenem-resistant A. baumannii. In this study, we retrospectively reviewed the medical records of patients more than 16 years of age with A. baumannii meningitis that developed after a neurosurgical procedure at five university-affiliated hospitals between January 2005 and May 2011. Of 40 cases identified, 22 (55.0 %) were caused by carbapenem-resistant strains. Of those evaluable 36 patients with A. baumannii meningitis, 14 (38.9 %) died of meningitis. Meningitis-related mortality was significantly related to carbapenem resistance (59.1 % versus 7.1 %; P = 0.002). In patients with meningitis caused by carbapenem-resistant A. baumannii, colistimethate-containing regimens (4/13 versus 7/9; P = 0.040), intrathecal or intraventricular (IT/IVR) administration of antibiotics (2/13 versus 8/9; P = 0.001), and combined intravenous and IT/IVR therapy (2/13 versus 6/9; P = 0.026) were significantly associated with cure. This study shows that use of colistimethate and combined systemic and local administration of antibiotics should be considered for the treatment of meningitis caused by carbapenem-resistant A. baumannii.

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Acknowledgments

This work was supported by the 2010 Inje University research grant.

Conflict of interest

We have no conflict of interest to declare.

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Authors and Affiliations

  1. Department of Internal Medicine, Inje University College of Medicine, Busan, Republic of Korea

    Chisook Moon, Yee Gyung Kwak & Baek-Nam Kim

  2. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea

    Eu Suk Kim

  3. Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea

    Chang-Seop Lee

  4. Department of Internal Medicine, Inje University Sanggye-Paik Hospital, Seoul, Republic of Korea

    Baek-Nam Kim

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  1. Chisook Moon
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  2. Yee Gyung Kwak
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  3. Baek-Nam Kim
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  4. Eu Suk Kim
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  5. Chang-Seop Lee
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Correspondence to Baek-Nam Kim.

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Moon, C., Kwak, Y.G., Kim, BN. et al. Implications of postneurosurgical meningitis caused by carbapenem-resistant Acinetobacter baumannii . J Infect Chemother 19, 916–919 (2013). https://doi.org/10.1007/s10156-013-0608-7

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  • DOI: https://doi.org/10.1007/s10156-013-0608-7

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