Acinetobacter species meningitis in children: a case series from Karachi, Pakistan
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...
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The Journal of Infection in Developing Countries
2011-11-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/1697 |
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| author | Ali Faisal Saleem Muhammad Shafaat Shah Abdul Sattar Shaikh Fatima Mir Anita K M Zaidi |
| author_facet | Ali Faisal Saleem Muhammad Shafaat Shah Abdul Sattar Shaikh Fatima Mir Anita K M Zaidi |
| author_sort | Ali Faisal Saleem |
| collection | DOAJ |
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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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| format | Article |
| id | doaj-art-ecb52a475e2d4b668108b66cea3003dc |
| institution | OA Journals |
| issn | 1972-2680 |
| language | English |
| publishDate | 2011-11-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-ecb52a475e2d4b668108b66cea3003dc2025-08-20T02:27:20ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802011-11-0151110.3855/jidc.1697Acinetobacter species meningitis in children: a case series from Karachi, PakistanAli Faisal Saleem0Muhammad Shafaat Shah1Abdul Sattar Shaikh2Fatima Mir3Anita K M Zaidi4The Aga Khan University Hospital, Karachi, PakistanThe Aga Khan University Hospital, Karachi, PakistanThe Aga Khan University Hospital, Karachi, PakistanThe Aga Khan University Hospital, Karachi, PakistanThe Aga Khan University Hospital, Karachi, Pakistan 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. https://jidc.org/index.php/journal/article/view/1697multidrug-resistant Acinetobacter meningitismortalitychildrenneurosurgical procedure |
| spellingShingle | Ali Faisal Saleem Muhammad Shafaat Shah Abdul Sattar Shaikh Fatima Mir Anita K M Zaidi Acinetobacter species meningitis in children: a case series from Karachi, Pakistan Journal of Infection in Developing Countries multidrug-resistant Acinetobacter meningitis mortality children neurosurgical procedure |
| title | Acinetobacter species meningitis in children: a case series from Karachi, Pakistan |
| title_full | Acinetobacter species meningitis in children: a case series from Karachi, Pakistan |
| title_fullStr | Acinetobacter species meningitis in children: a case series from Karachi, Pakistan |
| title_full_unstemmed | Acinetobacter species meningitis in children: a case series from Karachi, Pakistan |
| title_short | Acinetobacter species meningitis in children: a case series from Karachi, Pakistan |
| title_sort | acinetobacter species meningitis in children a case series from karachi pakistan |
| topic | multidrug-resistant Acinetobacter meningitis mortality children neurosurgical procedure |
| url | https://jidc.org/index.php/journal/article/view/1697 |
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