title: Clinical and bacteriological features of relapsing shunt-associated meningitis due to Acinetobacter baumannii.
abstract: A case is reported of a patient who developed Acinetobacter baumannii meningitis ten days after a ventriculoperitoneal shunt had been placed for control of elevated intracranial pressure. Intravenous antimicrobial therapy was instituted with imipenem and tobramycin after shunt removal and insertion of a ventriculostomy tube. Following the placement of a ventriculoatrial shunt, clinical and microbiological relapse occurred that was eventually cured after complete removal of the ventricular drainage system and a second course of systemic antibiotics. Relapse was confirmed by modern molecular typing techniques including plasmid DNA fingerprinting and analysis of total genomic DNA by pulsed-field gel electrophoresis.
authors.affiliation: Institute of Medical Microbiology and Hygiene, University of Cologne, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Seifert
authors.forename: W
authors.initials: W
authors.lastname: Richter
authors.forename: G
authors.initials: G
authors.lastname: Pulverer
mesh_terms: D000150:Acinetobacter / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D000151:Acinetobacter Infections / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D000328:Adult; D004269:DNA, Bacterial / Q000032:analysis; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D014031:Tobramycin / Q000627:therapeutic use; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*
chemical_list: D004269:DNA, Bacterial; D015378:Imipenem; D014031:Tobramycin