Nosocomial meningitis caused by Acinetobacter baumannii: risk factors and their impact on patient outcomes and treatments

Abstract

Aim: To increase our understanding of the clinical characteristics of nosocomial meningitis caused by Acinetobacter baumannii and provide a basis for improving its treatment. Materials & methods: A retrospective analysis was undertaken of 35 cases of A. baumannii meningitis to identify risk factors and their impact on patient outcomes (treatment effectiveness and survival rates). Results: Most patients were from a neurosurgery ward and had multidrug-resistant Acinetobacter infections. Brain neoplasms were the most frequent underlying disease. In total, 97.1% of patients had undergone surgical procedures within the previous month, mostly craniotomies with shunts. For treatment, intravenous carbapenems alone or combined with other antibiotics were used in 28 patients (80.0%), and were effective in 13 of these patients (46.4%). In addition to intravenous antibiotics, intrathecal therapy (gentamicin) or removal of all neurosurgical hardware was used in 18 patients (51.4%). Conclusion: In view of the lack of effective therapeutic options for the treatment of A. baumannii meningitis at the present time, there is a need for new therapies, well-controlled clinical trials of existing antimicrobial regimens and a greater emphasis on preventing nosocomial transmission of multidrug-resistant Acinetobacter strains.