Successful treatment of carbapenem-resistant Acinetobacter baumannii meningitis and purulent ventriculitis using cefiderocol combination therapy: a case report and literature review.

The application of cefiderocol in treating carbapenem-resistant Acinetobacter baumannii (CRAB) central nervous system (CNS) infections is rarely reported. Here we presented the case of a 66-year-old man with CRAB meningitis and purulent ventriculitis successfully treated with a combination antibiotic therapy including cefiderocol. Cerebrospinal fluid (CSF) analysis revealed normalization of glucose, chloride, protein, and lactate levels. CRAB cultures turned negative by Day 7, and metagenomics next generation sequencing (mNGS) results were negative by Day 25. The cefiderocol-contained regimen was continued for 41 days, with no recurrence of CRAB infection and no cefiderocol-associated adverse effects were observed. This case highlighted the potential of cefiderocol as a promising therapeutic option in treating CRAB CNS infections.