Neurosurgical meningitis due to Acinetobacter baumannii: comparasion between different treatments
Abstract number: p1368
Rodríguez-Guardado A., Blanco A., Torres J., Asensi V., Pintado V., Pérez F., Lantero M., Bustillo E., Maradona J., Cartón J.
The treatment of multidrug-resistant Acinetobacter baumannii meningitisis a serious therapeutic problem. We describe the outcome of nosocomial neurosurgical meningitis treated with different therapeutic options.
64 patients with nosocomial postsurgical meningitis due to Acinetobacter baumannii diagnosed between 19902004 were retrospectively reviewed.
Mean hospital stay before the infection was 26.5 [19.7] (limits 799 days); main underlying diseases were: intracerebral hemorrhage (45.3%), head trauma (29.7%) brain neoplasms (20.3%), and hydrocephalus (4.7%). 49 cases had intraventricular catheters, 4 had a ventriculoperitoneal shunt and 11 cases had CSF leakage. The most important treatment showed in table 1. Two patients dead without treatment. Although no patients treated with colistin dead and the mortality rate were lower in intrathecally treated patients (4 patients vs 18 p = 0.095) we have not observed statistically differences between the treatments. 22 patients dead due to the infection and the rest cure. The mortality was associated with no removal of CSF devices (p = 0.007, OR: 4.88 [1.2719.48]), inadequate treatment (p = 0.0002, OR: 1.467; [1.1021.951]), lack of stay in ICU (p = 0.041; OR: 3 [1.025-8.777]. and delayed in the beginning of treatment (p = 0.004)
Characteristics of antibiotics treatments
Nosocomial Acinetobacter meningitis have a high related mortality. This is lower in patients with intraventricular treatment. Colistin is a useful and safe option in the treatment of this entity.
|Session name:||XXIst ISTH Congress|
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