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Management of Meningitis Caused by Multi Drug-Resistant Acinetobacter Baumannii: Clinical, Microbiological and Pharmacokinetic Results in a Patient Treated with Colistin Methanesulfonate

This paper reports on a 71- year-old Caucasian male who underwent neurosurgery for an oligodendroglioma, followed by a cranial-sinus fistula and cerebrospinal fluid rhinorrhea. The clinical course was complicated due to an extensively drug-resistant Acinetobacter baumannii meningitis. The patient wa...

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Autores principales: Schiaroli, Elisabetta, Pasticci, Maria Bruna, Cassetta, Maria Iris, Fallani, Stefania, Castrioto, Corrado, Pirro, Matteo, Novelli, Andrea, De Angelis, Lucia Henrici, D’Andrea, Marco Maria, Mezzatesta, Maria Lina, Baldelli, Franco, Mencacci, Antonella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Università Cattolica del Sacro Cuore 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621166/
https://www.ncbi.nlm.nih.gov/pubmed/26543524
http://dx.doi.org/10.4084/MJHID.2015.055
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author Schiaroli, Elisabetta
Pasticci, Maria Bruna
Cassetta, Maria Iris
Fallani, Stefania
Castrioto, Corrado
Pirro, Matteo
Novelli, Andrea
De Angelis, Lucia Henrici
D’Andrea, Marco Maria
Mezzatesta, Maria Lina
Baldelli, Franco
Mencacci, Antonella
author_facet Schiaroli, Elisabetta
Pasticci, Maria Bruna
Cassetta, Maria Iris
Fallani, Stefania
Castrioto, Corrado
Pirro, Matteo
Novelli, Andrea
De Angelis, Lucia Henrici
D’Andrea, Marco Maria
Mezzatesta, Maria Lina
Baldelli, Franco
Mencacci, Antonella
author_sort Schiaroli, Elisabetta
collection PubMed
description This paper reports on a 71- year-old Caucasian male who underwent neurosurgery for an oligodendroglioma, followed by a cranial-sinus fistula and cerebrospinal fluid rhinorrhea. The clinical course was complicated due to an extensively drug-resistant Acinetobacter baumannii meningitis. The patient was treated with colistin methanesulfonate, intrathecal for 24 days and intravenous for 46 days. In addition, the patient received meropenem and teicoplanin to treat a urinary tract infection and a bacterial aspiration pneumonia. Cerebrospinal fluid trough colistin levels resulted above the MIC of A. baumannii. Colistin cerebrospinal fluid concentration did not increase over the treatment period. Meningitis was cured and A. baumannii eradicated. No side effects from the antimicrobial therapy were observed. In conclusion, this case highlights the issues in treating infections caused by resistant Gram negative bacteria and supports previous findings on the efficacy, pharmacokinetic and tolerability of intravenous and intrathecal colistin treatments.
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spelling pubmed-46211662015-11-05 Management of Meningitis Caused by Multi Drug-Resistant Acinetobacter Baumannii: Clinical, Microbiological and Pharmacokinetic Results in a Patient Treated with Colistin Methanesulfonate Schiaroli, Elisabetta Pasticci, Maria Bruna Cassetta, Maria Iris Fallani, Stefania Castrioto, Corrado Pirro, Matteo Novelli, Andrea De Angelis, Lucia Henrici D’Andrea, Marco Maria Mezzatesta, Maria Lina Baldelli, Franco Mencacci, Antonella Mediterr J Hematol Infect Dis Case Report This paper reports on a 71- year-old Caucasian male who underwent neurosurgery for an oligodendroglioma, followed by a cranial-sinus fistula and cerebrospinal fluid rhinorrhea. The clinical course was complicated due to an extensively drug-resistant Acinetobacter baumannii meningitis. The patient was treated with colistin methanesulfonate, intrathecal for 24 days and intravenous for 46 days. In addition, the patient received meropenem and teicoplanin to treat a urinary tract infection and a bacterial aspiration pneumonia. Cerebrospinal fluid trough colistin levels resulted above the MIC of A. baumannii. Colistin cerebrospinal fluid concentration did not increase over the treatment period. Meningitis was cured and A. baumannii eradicated. No side effects from the antimicrobial therapy were observed. In conclusion, this case highlights the issues in treating infections caused by resistant Gram negative bacteria and supports previous findings on the efficacy, pharmacokinetic and tolerability of intravenous and intrathecal colistin treatments. Università Cattolica del Sacro Cuore 2015-10-11 /pmc/articles/PMC4621166/ /pubmed/26543524 http://dx.doi.org/10.4084/MJHID.2015.055 Text en This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Schiaroli, Elisabetta
Pasticci, Maria Bruna
Cassetta, Maria Iris
Fallani, Stefania
Castrioto, Corrado
Pirro, Matteo
Novelli, Andrea
De Angelis, Lucia Henrici
D’Andrea, Marco Maria
Mezzatesta, Maria Lina
Baldelli, Franco
Mencacci, Antonella
Management of Meningitis Caused by Multi Drug-Resistant Acinetobacter Baumannii: Clinical, Microbiological and Pharmacokinetic Results in a Patient Treated with Colistin Methanesulfonate
title Management of Meningitis Caused by Multi Drug-Resistant Acinetobacter Baumannii: Clinical, Microbiological and Pharmacokinetic Results in a Patient Treated with Colistin Methanesulfonate
title_full Management of Meningitis Caused by Multi Drug-Resistant Acinetobacter Baumannii: Clinical, Microbiological and Pharmacokinetic Results in a Patient Treated with Colistin Methanesulfonate
title_fullStr Management of Meningitis Caused by Multi Drug-Resistant Acinetobacter Baumannii: Clinical, Microbiological and Pharmacokinetic Results in a Patient Treated with Colistin Methanesulfonate
title_full_unstemmed Management of Meningitis Caused by Multi Drug-Resistant Acinetobacter Baumannii: Clinical, Microbiological and Pharmacokinetic Results in a Patient Treated with Colistin Methanesulfonate
title_short Management of Meningitis Caused by Multi Drug-Resistant Acinetobacter Baumannii: Clinical, Microbiological and Pharmacokinetic Results in a Patient Treated with Colistin Methanesulfonate
title_sort management of meningitis caused by multi drug-resistant acinetobacter baumannii: clinical, microbiological and pharmacokinetic results in a patient treated with colistin methanesulfonate
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621166/
https://www.ncbi.nlm.nih.gov/pubmed/26543524
http://dx.doi.org/10.4084/MJHID.2015.055
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