Successful treatment of extensively drug-resistant Acinetobacter baumannii ventriculitis with polymyxin B and tigecycline- a case report

Antimicrob Resist Infect Control. 2018 Feb 14:7:22. doi: 10.1186/s13756-018-0313-5. eCollection 2018.

Abstract

Background: Acinetobacter baumannii nosocomial ventriculitis/meningitis, especially those due to drug-resistant strains, has substantially increased over recent years. However, limited therapeutic options exist for the Acinetobacter baumannii ventriculitis/meningitis because of the poor penetration rate of most antibiotics through the blood-brain barrier.

Case presentation: A 57-year-old male patient developed ventriculitis from an extensively drug-resistant strain of Acinetobacter baumannii after the decompressive craniectomy for severe traumatic brain injury. The patient was successfully treated with intraventricular and intravenous polymyxin B together with intravenous tigecycline.

Conclusions: The case illustrates intraventricular polymyxin B can be a therapeutic option against extensively drug-resistant Acinetobacter baumannii ventriculitis.

Keywords: Acinetobacter Baumannii; Intraventricular therapy; Multidrug resistance; Polymyxin B; Ventriculitis.

Publication types

  • Case Reports

MeSH terms

  • Acinetobacter baumannii / drug effects*
  • Acinetobacter baumannii / pathogenicity
  • Administration, Intravenous
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Blood-Brain Barrier
  • Brain Injuries / complications
  • Brain Injuries / diagnostic imaging
  • Cerebral Ventriculitis / diagnostic imaging
  • Cerebral Ventriculitis / drug therapy*
  • Cerebral Ventriculitis / microbiology
  • China
  • Drug Combinations
  • Drug Resistance, Multiple, Bacterial / drug effects*
  • Humans
  • Male
  • Meningitis, Bacterial / drug therapy
  • Middle Aged
  • Polymyxin B / administration & dosage
  • Polymyxin B / therapeutic use*
  • Tigecycline / administration & dosage
  • Tigecycline / therapeutic use*
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents
  • Drug Combinations
  • Tigecycline
  • Polymyxin B