title: [Postsurgical meningitis caused by Acinetobacter baumannii: study of 22 cases and review of the literature].
abstract: BACKGROUND
  Postsurgical Acinetobacter baumannii meningitis is associated with relevant morbidity and mortality. It has been related to neurosurgery, intraventricular catheters (IC) or CSF fistula. Thus, features, epidemiology and clinical course of this infection were studied.
  
  
  METHODS
  Retrospective analysis of 22 episodes of nosocomial postsurgical Acinetobacter baumannii meningitis. Twenty episodes occurred in males. The mean age of patients was 46 years (range: 16-83 years).
  
  
  RESULTS
  All patients were admitted to the ICU. In 50% of patients a history of intraventricular hemorrhage was recorded, 36% had had a skull fracture and the remaining patients had a brain tumor. In 18 cases the portal of entry was considered to be IC, in two an epidural catheter, and in two a CSF fistula. Patients showed a clinical picture indistinguishable from other types of meningitis, fever being the most common symptom (100%). CSF findings were consistent with bacterial meningitis. In one case the microorganism was recovered from blood. Fifteen patients recovered, three died as a direct result of the infection, and the remaining patients relapsed. Non recovery of patients was significantly associated with non removal of catheter (p < 0.05).
  
  
  CONCLUSIONS
  Postsurgical Acinetobacter baumannii meningitis occurs frequently in patients previously colonized with this microorganism in other sites and is enhanced by the presence of an IC. Catheter removal is essential for recovery of patients.
authors.affiliation: Servicios de Medicina Interna, Hospital Central de Asturias, Oviedo. bacterio@hca.es
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez Guardado
authors.forename: J A
authors.initials: JA
authors.lastname: Maradona
authors.forename: V
authors.initials: V
authors.lastname: Asensi
authors.forename: J A
authors.initials: JA
authors.lastname: Cartón
authors.forename: F
authors.initials: F
authors.lastname: Pérez
authors.forename: A
authors.initials: A
authors.lastname: Blanco
authors.forename: J M
authors.initials: JM
authors.lastname: Arribas
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*