Ampicillin-Sulbactam for Treatment of Carbapenem-Resistant Acinetobacter baumannii Meningitis

Carbapenem-resistant Acinetobacter baumannii (CRAB) is a rare but potentially fatal cause of post-neurosurgical meningitis, primarily due to its broad antimicrobial resistance and limited therapeutic options. We report the case of an eight-year-old girl who developed CRAB meningitis following ventriculoperitoneal shunt surgery. The organism was identified using standard biochemical methods and confirmed with an automated system (VITEK 2 Compact, BioMérieux SA, Marcy-l'Étoile, France). Antibiotic susceptibility testing revealed resistance to carbapenems and susceptibility only to colistin. The patient was treated successfully with a combination of high-dose intravenous ampicillin-sulbactam and intraventricular colistin following shunt exteriorization. Clinical improvement was observed within one week, and cerebrospinal fluid cultures subsequently became sterile. This case highlights the potential role of ampicillin-sulbactam, in combination with colistin, as an effective therapeutic option in managing post-neurosurgical CRAB meningitis, especially in pediatric patients where alternative agents are limited.