Epidemic iatrogenic Acinetobacter spp. meningitis following administration of intrathecal methotrexate

Alpha-hemolytic streptococci: A major pathogen of iatrogenic meningitis following lumbar puncture. Case reports and a review of the literature

“…or Acinetobacter spp. have been reported as causative agents of meningitis following lumbar puncture [3][4][5][6], but all incidental cases of iatrogenic meningitis reported after 1983 have been caused by streptococci. This shift can be attributed to the improved standard of hygiene involving sterility control, use of disposable syringes and single use of vials.…”

“…Less favourable statistics have been reported in a study conducted in Egypt; 17 out of 1,429 patients (1.2%) developed meningitis after spinal anesthesia [3]. Clusters and incidental cases of iatrogenic meningitis have been described following intrathecally administered drugs using contaminated c o m m o n vials for multiple administrations [4][5][6]. Recently, a cluster of two cases of streptococcal meningitis following myetography has been described [7].…”

Treatment of Multidrug-Resistant Acinetobacter baumannii Meningitis with Ampicillin/Sulbactam

“…Most of the reported cases have occurred in a neurosurgical setting and have been associated with indwelling ventriculostomytubes, CSF fistulae, or head trauma [6][7][8][9]. Nosocomial acinetobacter meningitis has been caused by the intrathecal administration of contaminated methotrexate solution to children with leukemia, with a mortality of 37.5% [10].…”

Iatrogenic meningitis after lumbar puncture—a preventable health hazard

“…9 The present study of 27 patients is the single largest series of IM, and there are two previous reports of IM from India. 5,12 In one of the studies, IM occurred after contamination of needle with Acinetobacter in eight of 20 children who received intra-thecal methotrexate. 5 In the second report, two patients developed IM after receiving intra-thecal interferon.…”