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Case Reports
. 2023 Sep 11:16:6029-6038.
doi: 10.2147/IDR.S425415. eCollection 2023.

Treatment of Central Nervous System Infection Caused by Multidrug-Resistant Acinetobacter baumannii with Intravenous and Intraventricular Colistin Sulfate: A Case Report and Literature Review

Xueping Yang #  1   2 , Changhong Guo #  3 , Guangjie Wu #  1 , Kai Zhao  4 , Dong Xiang  1 , Dong Xu  5 , Dong Liu  1 , Yan He  1
Affiliations
Case Reports

Treatment of Central Nervous System Infection Caused by Multidrug-Resistant Acinetobacter baumannii with Intravenous and Intraventricular Colistin Sulfate: A Case Report and Literature Review

Xueping Yang et al. Infect Drug Resist. .

Abstract

Purpose: Due to the spread of antimicrobial-resistant bacteria and poor penetration of many antimicrobial drugs across the blood-brain barrier following intravenous administration, treatment of central nervous system (CNS) infections is challenging, especially infections caused by carbapenem-resistant organisms (CRO). Intraventricular (IVT) infusion of antimicrobial drugs could be a choice. This report aims to describe a patient with CNS infection caused by carbapenem-resistant Acinetobacter baumannii (CRAB) which was successfully treated with IVT combined with intravenous (IV) colistin sulfate.

Methods: A case of CNS infection caused by CRAB after a craniocerebral injury was presented. The patient was treated with IVT together with IV colistin sulfate. Moreover, literature on the regimens and safety of colistin sulfate were also reviewed and summarized.

Results: Intraventricular (50,000 U, qd/100,000 U, qd) combined with IV (500,000 U, q12h/500,000 U, q8h) colistin sulfate was given to the patient, and the CNS infection was successfully controlled. The patient was finally transferred back to a local hospital for rehabilitation treatment. No nephrotoxicity or neurotoxicity was observed during the therapy.

Conclusion: IV combined with IVT colistin sulfate is effective in the treatment of CNS infections caused by CRAB. IVT concomitant IV colistin sulfate might be a therapeutic option worth considering in the treatment of CNS infections caused by CRO.

Keywords: Acinetobacter baumannii; central nervous system infection; colistin; colistin sulfate; intraventricular administration; polymyxin.

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Conflict of interest statement

The authors declare that they have no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The brain CT images during hospitalization. (A) The Brain CT on January 13 (on postoperative Day 2); (B) the Brain CT on January 27 (on postoperative Day 17). The areas indicated by the red arrows in (A and B) are the sites of infection. After treatment, a significant improvement in infection was seen, as shown in (B).
See this image and copyright information in PMC

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