Colistin-resistant<i>Acinetobacter baumannii</i>as a cause of neonatal ventriculitis

Mahabeer, Prasha; Mzimela, Bongani W; Lawler, Melissa; Singh-Moodley, Ashika; Singh, Rachna; Mlisana, Koleka

doi:10.1080/23120053.2018.1509183

Cited by 2 publications

(4 citation statements)

References 6 publications

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“…In our study, neonatal CSF became sterile within an average of 3.72 days (range 2-8 days), which is similar to earlier literature (56,57). Previous adult and pediatric studies have concluded that the use of IT/IVT colistin was found safe and effective (56,57).…”

Section: Discussionsupporting

confidence: 90%

“…In another review, Katragkou et al discussed the treatment of MDR A. baumannii-associated CNS infection by using IVT/IT colistin alone or as an adjunctive to systemic antimicrobials (55). In our study, neonatal CSF became sterile within an average of 3.72 days (range 2-8 days), which is similar to earlier literature (56,57). Previous adult and pediatric studies have concluded that the use of IT/IVT colistin was found safe and effective (56,57).…”

Section: Discussionsupporting

confidence: 88%

“…In addition, combination therapy with colistin, meropenem, and ampicillinsulbactam has been reported to reduce the mortality rate (21). Colistin resistance among A. baumannii and K. pneumonia are increasingly reported and a case report from South Africa identified the presence of colistin-resistant A baumanniiassociated ventriculitis in a neonate (56). Another case report by Mehar et al reported septicemia with meningitis due to carbapenem-resistant (susceptible to colistin) A. baumannii in a preterm neonate.…”

Section: Discussionmentioning

confidence: 99%

“…The increasing prevalence of MDRO causing neonatal sepsis including meningitis and ventriculitis in some middle-and low-income countries is a matter of great concern (41,56). Also, the implementation of infection control and prevention strategies is a global challenge in these regions to control the spread of MDR-GNB.…”

Section: Discussionmentioning

confidence: 99%

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Neurodevelopment Outcome of Neonates Treated With Intraventricular Colistin for Ventriculitis Caused by Multiple Drug-Resistant Pathogens—A Case Series

et al. 2021

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Background: Multiple-drug-resistant Gram-negative bacteria (MDR-GNB)-associated neonatal ventriculitis is a life-threatening complication that needs timely diagnosis and effective treatment with broad-spectrum antimicrobials in critical-care settings. Inadequate penetration of antibiotics through the blood–brain barrier also demands an intraventricular (IVT) route of administration. This study reports mortality and neurodevelopmental sequelae of neonates till 18 months of age, who received IVT-colistin for treating MDR-GNB associated ventriculitis.Methods: In a case series of seven neonates with ventriculitis due to MDR-GNB at NICU of Aga Khan University Hospital, Pakistan, between June 2015 and 2018, we reviewed IVT-colistin therapy in critically ill neonates. Treatment outcomes were assessed based on clinical sign's resolution and MDR-GNB eradication in subsequent CSF cultures. Neurodevelopmental outcomes were evaluated at 18 months after discharge.Results: The average birth weight was 1.38 kg (range: 1.02–1.5 kg), and the average gestational age was 30.7 weeks (ranged: 26–34 weeks). All neonates reported colistin-sensitive MDR-GNB in CSF, five with Acinetobacter baumannii, and polymicrobial CNS infection was found in two patients (one due to Klebsiella pneumonia and A. baumannii and one due to K. pneumonia and Escherichia coli). All neonates received IVT colistin and concomitant intravenous meropenem, and five of them also received intravenous colistin. One neonate died. At the 18-month assessment, only one neonate had cerebral palsy and hydrocephaly and 50% had seizure disorders.Conclusion: Practicing intraventricular antibiotics in the neonatal population is challenging but may be used successfully, especially to overcome the limitation of poor penetration through the blood–brain barrier.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Neurodevelopment Outcome of Neonates Treated With Intraventricular Colistin for Ventriculitis Caused by Multiple Drug-Resistant Pathogens—A Case Series

et al. 2021

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Intrathecal/Intraventricular Colistin for Antibiotic-Resistant Bacterial CNS Infections in Pediatric Population: A Systematic Review

Alnaami

Alahmari

2022

TropicalMed

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Central nervous system (CNS) infections constitute a life-threatening condition, especially in children. Treatment limitations exist for drug-resistant CNS bacterial infections. Inadequate CNS penetration and intravenous (IV) antibiotic treatment failure represent a major clinical challenge. However, patients with antibiotic-resistant bacterial CNS infections may benefit from intrathecal (IT) or intraventricular (IVT) colistin. The authors aimed to assess the safety and effectiveness of IT/IVT colistin therapy in the pediatric population, with or without other antibiotics, for the treatment of antibiotic-resistant CNS infections. A comprehensive literature search was conducted using the electronic databases of PubMed, Ovid, and Embase for relevant articles using the following terms: “Colistin”, “CNS infection”, and “Outcome”, as well as their combinations. The retrieved articles were filtered by age (Child), language (English), route of administration (IT/IVT), and species (Humans). The present systematic review comprised 20 articles that included 31 children (19; 61.2% were boys) with multidrug-resistant CNS infection. Their ages ranged from less than one month to 18 years (median: 9 months). Acinetobacter baumannii was the main causative organism in 22 patients (70.9%), and infection occurred mainly after neurosurgical interventions (83.8%). An external ventricular drain was inserted to administer colistin into the ventricular system in 29 cases (93.5%). The median duration for colistin therapy was 18 days. Twenty-three patients (74%) recovered, while five patients (16%) had residual disability, and three patients (10%) died. The authors concluded that IT/IVT colistin therapy is safe and effective as either the primary or adjunct treatment for antibiotic-resistant cases with CNS infection.

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Colistin-resistantAcinetobacter baumanniias a cause of neonatal ventriculitis

Cited by 2 publications

References 6 publications

Neurodevelopment Outcome of Neonates Treated With Intraventricular Colistin for Ventriculitis Caused by Multiple Drug-Resistant Pathogens—A Case Series

Neurodevelopment Outcome of Neonates Treated With Intraventricular Colistin for Ventriculitis Caused by Multiple Drug-Resistant Pathogens—A Case Series

Intrathecal/Intraventricular Colistin for Antibiotic-Resistant Bacterial CNS Infections in Pediatric Population: A Systematic Review

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