title: Colistin and tigecycline for management of external ventricular device-related ventriculitis due to multidrug-resistant Acinetobacter baumannii.
abstract: Acinetobacter baumannii is an important cause of nosocomial ventriculitis associated with external ventricular device (EVD). It is frequently multidrug resistant (MDR), carries a poor outcome, and is difficult to treat. We report a case of MDR Acinetobacter ventriculitis treated with intravenous and intraventricular colistin together with intravenous tigecycline. The patient developed nephrotoxicity and poor neurological outcome despite microbiological cure. Careful implementation of bundle of measures to minimize EVD-associated ventriculitis is valuable.
authors.affiliation: Department of Anaesthesiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Gentle Sunder
authors.initials: GS
authors.lastname: Shrestha
authors.affiliation: Department of Anaesthesiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Sushil
authors.initials: S
authors.lastname: Tamang
authors.affiliation: Department of Anaesthesiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Hem Raj
authors.initials: HR
authors.lastname: Paneru
authors.affiliation: Department of Anaesthesiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Pramesh Sunder
authors.initials: PS
authors.lastname: Shrestha
authors.affiliation: Department of Anaesthesiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Niraj
authors.initials: N
authors.lastname: Keyal
authors.affiliation: Department of Anaesthesiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Subhash Prasad
authors.initials: SP
authors.lastname: Acharya
authors.affiliation: Department of Anaesthesiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Moda Nath
authors.initials: MN
authors.lastname: Marhatta
authors.affiliation: Department of Surgery, Neurosurgery Unit, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Sushil
authors.initials: S
authors.lastname: Shilpakar
keywords: Acinetobacter baumannii; colistin; intraventricular; multidrug resistant; tigecycline; ventriculitis