title: Successful treatment of extensively drug-resistant Acinetobacter baumannii ventriculitis and meningitis with intraventricular colistin after application of a loading dose: a case series.
abstract: Treatment results of six post-neurosurgical ventriculitis and meningitis cases caused by extensively drug-resistant Acinetobacter baumannii after application of an intraventricular loading dose of 500000 IU (40 mg) of colistin followed by a dose of 125000-250000 IU (10-20 mg) every 24-48 h plus parenteral colistin are reported. Simultaneous bacteraemia with an identical Acinetobacter strain was observed in three patients. The mean duration of treatment was 17.2 days (range 15-21 days) and the median time of sterilisation of cerebrospinal fluid was 2.5 days (range 1-5 days). All patients were cured, however one patient presented with chemical meningitis and one with chemical ventriculitis, conditions that clinically and biochemically resemble bacterial meningitis.
authors.affiliation: 6th Department of Internal Medicine, Hygeia General Hospital, 4 Erythrou Stavrou Str. & Kifissias Ave., Marousi 15123, Athens, Greece.
authors.forename: Ilias
authors.initials: I
authors.lastname: Karaiskos
authors.forename: Lambrini
authors.initials: L
authors.lastname: Galani
authors.forename: Fotini
authors.initials: F
authors.lastname: Baziaka
authors.forename: Emmanouela
authors.initials: E
authors.lastname: Katsouda
authors.forename: Ioannis
authors.initials: I
authors.lastname: Ioannidis
authors.forename: Alexandros
authors.initials: A
authors.lastname: Andreou
authors.forename: Harry
authors.initials: H
authors.lastname: Paskalis
authors.forename: Helen
authors.initials: H
authors.lastname: Giamarellou
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy*; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D058565:Cerebral Ventriculitis / Q000150:complications / Q000188:drug therapy*; D002555:Cerebrospinal Fluid / Q000382:microbiology; D003091:Colistin / Q000008:administration & dosage*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D057967:Infusions, Intraventricular; D008297:Male; D008581:Meningitis / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D013530:Surgical Wound Infection / Q000188:drug therapy; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D003091:Colistin