Méningite néonatale à Acinetobacter baumanii traitée par la colistine intraventriculaire

Alaoui, S.Y.; Nejmi, S.E.; Chakir, A.A.; Hmamouchi, B.; Chlilek, A.

doi:10.1016/j.annfar.2011.07.008

Cited by 19 publications

(8 citation statements)

References 5 publications

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“…Furthermore, Acinetobacterbaumannii are known for their multiple antibiotic resistance,are nosocomial infections whose treatment is a real therapeutic challenge, given the lack of efficient antibiotics and the lack of consensus concerning this clinical situation. Intrathecal or intravenous colistin seems to be a solution to this problem [13].…”

Section: Discussionmentioning

confidence: 99%

Bacterial Meningitis Profile in Newborns: Is the Epidemiology Changing?

Bennaoui¹,

Slitine²,

Cissé³

et al. 2018

TOIDJ

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Objective: The aim of the study was to determine the epidemiological characteristics of bacterial meningitis observed in neonates. Materials and Methods: A retrospective study of all cases of meningitis, hospitalized in the neonatal intensive care unit, Mohamed VI University Hospital, from January 2016 to December 2016. Results: Twenty of 794 neonates admitted (2.5%) developed meningitis,with a male predominance (12 boys). The mean age of symptom presentation was 5 days. All patients were symptomatic. The most common clinical features were: fever, respiratory distress and seizure. Microbiological analysis of cerebrospinal fluid was positive in 14 cases and resulted in the isolation of several unusual species such as, Streptococcus pneumoniae (4 cases), Coagulase-negative Staphylococci (3 cases), Enterococci (2 cases), Acinetobacter baumannii (2 cases) and one case each of Escherichia coli , Neisseria meningitidis and Klebsiella pneumonia. Interestingly, the two A. baumannii cases were nosocomially-acquired, while the origins of the other infections were community-acquired. Gram-positive bacteria were more frequently responsible (9/14, 64%). All cases were treated with a combination of third-generation cephalosporins-aminoglycosides, 1 case as treated by by adding ciprofloxacin and 3 cases were treated by adding glycopeptide antibiotics to the clinical therapeutic regimes. We reported 3 cases complicated with hydrocephalus. The mortality rate was 25%. Conclusion: Bacterial meningitis is a medical emergency, and immediate diagnostic steps must be taken to establish the specific cause so that appropriate antimicrobial therapy can be initiated. Even with optimal therapy, morbidity and mortality may occur. Neurologic sequelae are common among survivors.

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Section: Discussionmentioning

confidence: 99%

Bacterial Meningitis Profile in Newborns: Is the Epidemiology Changing?

Bennaoui¹,

Slitine²,

Cissé³

et al. 2018

TOIDJ

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“…However, in the literature, data regarding intraventricular colistin usage in the neonatal period are very limited. Alaoui et al ( 2 ) reported that ventriculitis and meningitis in a four-day-old term neonate with meningomyelocele were treated successfully with intraventricular colistin. To the best of our knowledge, our patient represents the second newborn infant that was treated with intraventricular colistin.…”

Section: Discussionmentioning

confidence: 99%

“…Especially, MDR gram-negative bacterial infections appear as a significant cause of mortality and morbidity in NICUs. The number of antibiotic options for the treatment of these infections is limited ( 1 , 2 ). The incidence of nosocomial infections in NICUs range between 7% - 24% ( 3 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Intravenous Colistin in Neonates With Culture Proven Sepsis

et al. 2015

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Background:Although it is well described among adults, intravenous colistin use and its associated toxicities in newborns are poorly understood.Objectives:We present our experience of efficacy and safety of intravenous colistin in the treatment of sepsis in term and preterm neonates.Patients and Methods:The records of neonates who received colistin between January 2013 and February 2014 were retrospectively reviewed. All neonates with culture proven nosocomial infections due to multidrug resistant organisms and treated continuously with colistin for more than 72 hours were included in the study.Results:Patients were evaluated for clinical and microbiological response to the drug and its and side effects. Twelve newborn infants with mean 31.8 ± 3.5 weeks gestational age and median 1482 (810 - 3200) gram birth weight were included. 11/12 (91.7%) patients showed microbiological clearance with intravenous colistin. One patient who had recurrent cerebrospinal fluid positive culture was treated with intraventricular colistin. The major side effects observed was hyponatremia and hypokalemia in 2 (16.6%) patients, all infants required magnesium supplementation.Conclusions:Intravenous colistin administration appears to be safe and efficacious for multidrug-resistant gram-negative infections in neonates, including preterm infants. However, we believe that large prospective controlled studies are needed to confirm its efficacy and safety in neonates.

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“…The drug has poor CNS penetrability. However, intraventricular or intrathecal routes have been used successfully for CNS infections 74 . For pulmonary infections, administration via inhalational route may ensure more concentration of the drug in pulmonary parenchyma 75 .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of evidence for pharmacokinetics-pharmacodynamics-based dose optimization of antimicrobials for treating Gram-negative infections in neonates

Shafiq

Malhotra

Gautam

et al. 2017

Indian Journal of Medical Research

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Background & objectives: Neonates present a special subgroup of population in whom optimization of antimicrobial dosing can be particularly challenging. Gram-negative infections are common in neonates, and inpatient treatment along with critical care is needed for the management of these infections. Dosing recommendations are often extrapolated from evidence generated in older patient populations. This systematic review was done to identify the knowledge gaps in the pharmacokinetics-pharmacodynamics (PK-PD)-based optimized dosing schedule for parenteral antimicrobials for Gram-negative neonatal infections. Methods: Relevant research questions were identified. An extensive electronic and manual search methodology was used. Potentially eligible articles were screened for eligibility. The relevant data were extracted independently in a pre-specified data extraction form. Pooling of data was planned. Results: Of the 340 records screened, 24 studies were included for data extraction and incorporation in the review [carbapenems - imipenem and meropenem (n=7); aminoglycosides - amikacin and gentamicin (n=9); piperacillin-tazobactam (n=2); quinolones (n=2); third- and fourth-generation cephalosporins (n=4) and colistin nil]. For each of the drug categories, the information for all the questions that the review sought to answer was incomplete. There was a wide variability in the covariates assessed, and pooling of results could not be undertaken. Interpretation & conclusions: There is a wide knowledge gap for determining the doses of antimicrobials used for Gram-negative infections in neonates. A different profile of newborns in the developing countries could affect the disposition of antimicrobials for Gram negative infections, necessitating the generation of PK-PD data of antimicrobials in neonates from developing countries. Further, guidelines for treatment of neonatal conditions may incorporate the evidence-based PK-PD-guided dosing regimens.

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Méningite néonatale à Acinetobacter baumanii traitée par la colistine intraventriculaire

Cited by 19 publications

References 5 publications

Bacterial Meningitis Profile in Newborns: Is the Epidemiology Changing?

Bacterial Meningitis Profile in Newborns: Is the Epidemiology Changing?

Safety and Efficacy of Intravenous Colistin in Neonates With Culture Proven Sepsis

Evaluation of evidence for pharmacokinetics-pharmacodynamics-based dose optimization of antimicrobials for treating Gram-negative infections in neonates

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