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Meningitis due to Ochrobactrum anthropi: an emerging nosocomial pathogen. A report of 3 cases
J C Christenson1, A T Pavia, K Seskin
1University of Utah School of Medicine, Division of Pediatric Infectious Diseases, Salt Lake City 84132, USA. jchristn@med.utah.edu
Abstract:
We describe 3 cases of Ochrobactrum anthropi meningitis following the implantation of pericardial allograft tissue to cover dural defects following craniotomy. Following an extensive epidemiologic investigation, the tissue allograft was found to have been contaminated with this unusual organism during the harvesting and processing of the tissue in the tissue bank. This organism was only susceptible to imipenem, tetracycline, gentamicin, and ciprofloxacin. The clinical presentation of these patients was subacute. Two of the patients developed osteomyelitis of the bone flap; while another developed a relapse of infection along a former ventriculoperitoneal shunt track 6 months after the initial infection. Appropriate clinical outcome was only observed after removal of tissue allograft implants, debridement of devitalized tissue and bone, removal of shunt devices, and prolonged courses of antibiotics. No deaths were observed.
Insights
Ochrobactrum anthropi meningitis can occur after dural defect repair with contaminated pericardial allografts. Successful treatment requires allograft removal, debridement, and prolonged antibiotic therapy.
Area of Science:
- Infectious Diseases
- Neurosurgery
- Microbiology
Background:
- Dural defects following craniotomy pose a risk for central nervous system infections.
- Allograft tissues, such as pericardium, are used for dural repair.
- Contamination of allograft materials can lead to opportunistic infections.
Observation:
- Three cases of meningitis caused by Ochrobactrum anthropi are presented.
- The infections were linked to contaminated pericardial allograft tissue used for dural repair.
- Ochrobactrum anthropi exhibited susceptibility to imipenem, tetracycline, gentamicin, and ciprofloxacin.
Findings:
- Patients presented with subacute meningitis.
- Complications included osteomyelitis of the bone flap and late-onset shunt-track infection.
- Infection resolution required surgical intervention and extended antibiotic treatment.
Implications:
- Highlights the risk of allograft contamination in neurosurgical procedures.
- Emphasizes the importance of rigorous tissue banking and screening protocols.
- Demonstrates the necessity of aggressive surgical management combined with targeted antibiotics for refractory Ochrobactrum anthropi infections.