Antibiotic-resistant Acinetobacter meningitis in neurosurgical patients

Acinetobacter anitratus has emerged as one of the common pathogens responsible for postneurosurgical meningitis at the authors' institution. Seven patients with Acinetobacter meningitis were identified during the 4-year period of this study, five of whom acquired organisms susceptible only to imipenem and amikacin. Acinetobacter bacteremia occurred concomitantly in five patients. Despite late institution of therapy as a result either of organism misidentification on Gram stain or of unexpected acquisition of a highly resistant organism, the patients' outcome was favorable after the initiation of appropriate antibiotic therapy. Imipenem and amikacin, with or without intrathecal aminoglycosides, were effective in patients with resistant strains of Acinetobacter.