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Updated: Aug 15, 2026

Separation of the Cell Envelope for Gram-negative Bacteria into Inner and Outer Membrane Fractions with Technical Adjustments for Acinetobacter baumannii
10:24

Separation of the Cell Envelope for Gram-negative Bacteria into Inner and Outer Membrane Fractions with Technical Adjustments for Acinetobacter baumannii

Published on: April 10, 2020

Adult Acinetobacter meningitis and its comparison with non-Acinetobacter gram-negative bacterial meningitis

Shu-Fang Chen1, Wen-Neng Chang, Cheng-Hsien Lu

  • 1Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung, Taiwan.

Acta Neurologica Taiwanica
|October 29, 2005
PubMed

Insights

Acinetobacter meningitis, particularly post-neurosurgical cases, shows high antibiotic resistance. Meropenem is a potential initial treatment for this challenging Gram-negative bacterial meningitis.

Area of Science:

  • Infectious Diseases
  • Neuroscience
  • Microbiology

Background:

  • Gram-negative bacterial meningitis (GNBM) is a serious infection.
  • Acinetobacter species are increasingly recognized pathogens, especially in hospital-acquired infections.
  • Post-neurosurgical meningitis presents unique management challenges due to potential resistance patterns.

Purpose of the Study:

  • To investigate the clinical features and antibiotic susceptibility of Acinetobacter meningitis in adult patients.
  • To compare Acinetobacter meningitis with other Gram-negative bacterial meningitis (GNBM) cases.
  • To identify challenges and guide initial management strategies for Acinetobacter meningitis.

Main Methods:

  • Retrospective analysis of 81 adult bacterial meningitis cases from 1999-2003.
  • Comparison of 13 Acinetobacter meningitis cases with 68 non-Acinetobacter GNBM cases.
  • Analysis of antibiotic susceptibility testing for Acinetobacter strains from cerebrospinal fluid.

Main Results:

  • Acinetobacter meningitis occurred in 13 cases, predominantly A. baumannii (12/13), with 11 post-neurosurgical infections.
  • High resistance rates were observed for ceftriaxone (8%), ciprofloxacin (46%), ceftazidime (46%), cefepime (54%), ampicillin-sulbactam (54%), with high susceptibility to imipenem (92%) and meropenem (92%).
  • A pan-drug resistant A. baumannii strain emerged in 2003. Acinetobacter meningitis was associated with hydrocephalus and ceftazidime resistance. Mortality was 30%, with significant neurological deficits in survivors.

Conclusions:

  • Acinetobacter meningitis, especially in post-neurosurgical settings, is challenging due to multidrug resistance and the emergence of pan-drug resistant strains.
  • Carbapenems, particularly meropenem, should be considered for initial empiric antibiotic therapy in adult post-neurosurgical meningitis.
  • Early recognition and appropriate antibiotic selection are crucial for improving outcomes in Acinetobacter meningitis.

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