Acinetobacter Meningitis: A Retrospective Study on its Incidence and Mortality Rates in Postoperative Patients at a Tertiary Care Centre in Northern India

Abstract

Introduction: Acinetobacter species is a non fermenting, Gram negative bacillus, a causative pathogen of hospital-acquired infections due to its inherent Multidrug-Resistant (MDR) property. It is held responsible for the majority of nosocomial meningitis in patients undergoing neurosurgical procedures. Aim: To identify the clinical characteristics, drug-resistance and mortality rate among the patients suffering from meningitis caused by Acinetobacter baumannii. Materials and Methods: This retrospective study was carried out in the Bacteriology section of the Department of Microbiology at Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India, from February 2019 to February 2022. A total of 150 Cerebrospinal Fluid (CSF) samples from routine bacterial culture-confirmed patients were included in the study. All clinical data were extracted from the Hospital Information System (HIS). All the isolates were identified by Matrix Assisted Laser Desorption/Ionisation-Time of FlightMass Spectrometry (MALDI-TOF-MS) assay and antibiotic sensitivity testing was performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: The study included 150 (7.55%) cases of culture-proven bacterial meningitis among 1,986 CSF samples collected from February 2019 to February 2022. There were 45 (30.0%) cases of Acinetobacter meningitis. Thirty-five (77.8%) patients had undergone neurosurgical procedures for the removal of spaceoccupying lesions from the brain parenchyma. Forty-two (93.3%) isolates were resistant to amikacin and a cumulative resistance of almost 93.3% to 95.6% was observed among cephalosporins. Fluoroquinolone resistance was observed in 43 (95.6%) patients and carbapenem resistance was observed in 42 (93.33%) isolates. Overall, 12 (26.7%) succumbed to their infections. Conclusion: Acinetobacter meningitis causes delay in the recovery of the patient undergoing intracranial surgery, amounting to a delay in brain parenchyma healing in the case of neurosurgical patients.