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Acinetobacter baumannii meningitis in children: a case series and literature review

Jiying Xiao1, Chenmei Zhang2, Sheng Ye3

  • 1Department of Pediatric Medicine, Hangzhou Children's Hospital, No. 195 Wenhui Rd, Xiacheng District, Hangzhou, 310015, China.

Infection
|October 18, 2018
PubMed
Abstract

Insights

Pediatric Acinetobacter baumannii meningitis, often linked to neurosurgery, presents a high mortality risk, especially with drug-resistant strains. Polymyxin administration shows promise but needs further investigation.

Area of Science:

  • Infectious Diseases
  • Pediatric Neurology
  • Critical Care Medicine

Background:

  • Acinetobacter baumannii meningitis incidence is rising, particularly in pediatric patients post-neurosurgery.
  • The emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains poses significant clinical challenges.

Observation:

  • A retrospective review of nine pediatric meningitis cases due to Acinetobacter baumannii was conducted.
  • Seven patients had prior neurosurgery, with cultures taken an average of 23.7 days post-operation.
  • Resistant isolates included four MDR, two XDR, and one pan-drug-resistant (PDR) strain.

Findings:

  • Mortality reached 44% (four of nine patients), with deaths occurring in cases of MDR, PDR, and susceptible Acinetobacter infections.
  • Treatment involved intrathecal amikacin, intravenous colistin, and polymyxin B.
  • Mean hospitalization was 39.4 days, with some patients having positive cerebrospinal fluid (CSF) cultures at death.

Implications:

  • Acinetobacter baumannii meningitis is strongly associated with neurosurgery and foreign materials, carrying a high mortality rate.
  • Intrathecal or intraventricular polymyxin may be an effective treatment strategy, warranting further clinical studies.
Keywords:
Acinetobacter baumanniiChildrenPolymyxinPostoperative meningitis

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