Nosocomial meningitis caused by Acinetobacter baumannii: risk factors and their impact on patient outcomes and treatments.
OBJECTIVE
To increase our understanding of the clinical characteristics of nosocomial meningitis caused by Acinetobacter baumannii and provide a basis for improving its treatment.


METHODS
A retrospective analysis was undertaken of 35 cases of A. baumannii meningitis to identify risk factors and their impact on patient outcomes (treatment effectiveness and survival rates).


RESULTS
Most patients were from a neurosurgery ward and had multidrug-resistant Acinetobacter infections. Brain neoplasms were the most frequent underlying disease. In total, 97.1% of patients had undergone surgical procedures within the previous month, mostly craniotomies with shunts. For treatment, intravenous carbapenems alone or combined with other antibiotics were used in 28 patients (80.0%), and were effective in 13 of these patients (46.4%). In addition to intravenous antibiotics, intrathecal therapy (gentamicin) or removal of all neurosurgical hardware was used in 18 patients (51.4%).


CONCLUSIONS
In view of the lack of effective therapeutic options for the treatment of A. baumannii meningitis at the present time, there is a need for new therapies, well-controlled clinical trials of existing antimicrobial regimens and a greater emphasis on preventing nosocomial transmission of multidrug-resistant Acinetobacter strains.
Emergency Department, Huashan Hospital, Fudan University, Wulumuqi Road 12, Shanghai 200040, China.
Minjie
M
Yang
Zupeng
Z
Hu
Fupin
F
Hu
D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000302:isolation & purification*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult