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

INTRODUCTION

The incidence of Acinetobacter baumannii meningitis, which typically occurs after neurosurgery, has increased in recent years. Pediatric Acinetobacter baumannii meningitis due to the emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains has important clinical significance.

METHODOLOGY: We retrospectively reviewed the clinical course and outcome of nine cases of meningitis due to Acinetobacter baumannii in children and reviewed the relevant literature.

RESULTS

Seven patients had a history of neurosurgery, and the average time from the first surgery to cerebrospinal fluid (CSF) culture in these seven patients was 23.71 ± 17.43 days. Of all nine patients, four patients showed MDR isolates, two showed XDR isolates, and one showed pan-drug-resistant (PDR) isolates. Three patients received an intrathecal injection of amikacin. Two patients received intravenous colistin (5 mg/kg), and one received polymyxin B (2 mg/kg). The mean hospitalization duration was 39.44 days. Four patients eventually died: two with MDR Acinetobacter, one with PDR Acinetobacter, and one with susceptible Acinetobacter. Two of them still had positive CSF cultures at death.

CONCLUSION

Acinetobacter baumannii meningitis is usually associated with neurosurgery and the placement of foreign material, and it usually has a high mortality. Intrathecal or intraventricular polymyxin administration is expected to be an effective choice for meningitis but requires further study.