Successful treatment of postoperative multidrug-resistant Acinetobacter baumannii meningitis by tigecycline

Kooli, I.; Brahim, H. Ben; Kilani, M.; Gannouni, C.; Aouam, A.; Toumi, A.; Loussaief, C.; Hattab, Mohamed Nejib; Chakroun, M.

doi:10.1016/j.jgar.2015.12.003

Cited by 12 publications

(10 citation statements)

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“…Aminoglycosides, for instance, presented susceptibilities rates ranging from 31.8% to tobramycin to only 9.3% to amikacin. Despite the controversies, tigecycline can be considered one of the few therapeutic options for treatment of MDR infection in skin and soft tissue infections and meningitis (Montravers et al, 2013; Kooli et al, 2016; Lauretti et al, 2017). Still tigecycline is not recommended for the treatment of ventilator-associated pneumonia and BSI (http://www.fda.gov/drugs/drugsafety/ucm224370.htm), we evaluate the tigecycline activity in our BSI isolates with surveillance purposes and no resistance was observed, even this phenotype becomes progressively more common in A. baumannii in several countries (Navon-Venezia et al, 2007; Al-Sweih et al, 2011; Montravers et al, 2013; Sun et al, 2013; Provasi Cardoso et al, 2016; Vasconcellos et al, 2017a; Royer et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Emergence and Persistence of High-Risk Clones Among MDR and XDR A. baumannii at a Brazilian Teaching Hospital

et al. 2019

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Dissemination of carbapenem-resistant Acinetobacter baumannii is currently one of the priority themes discussed around the world, including in Brazil, where this pathogen is considered endemic. A total of 107 carbapenem-resistant A. baumannii (CRAB) isolates were collected from patients with bacteraemia attended at a teaching hospital in Brazil from 2008 to 2014. From these samples, 104 (97.2%) carried blaOXA−23−like, all of them associated with ISAba1 The blaOXA−231 (1.9%) and blaOXA−72 (0.9%) genes were also detected in low frequencies. All isolates were susceptible to minocycline, and 38.3% of isolates presented intermediate susceptibility to tigecycline (MIC = 4 μg/ml). Molecular typing assessed by multi-locus sequence typing demonstrated that the strains were mainly associated with clonal complexes CC79 (47.4%), followed by CC1 (16.9%), and CC317 (18.6%), belonging to different pulsotypes and in different prevalences over the years. Changes in the clones' prevalence reinforce the need of identifying and controlling CRAB in hospital settings to preserve the already scarce therapeutic options available.

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Section: Discussionmentioning

confidence: 99%

Emergence and Persistence of High-Risk Clones Among MDR and XDR A. baumannii at a Brazilian Teaching Hospital

et al. 2019

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“…The reviewed six articles which met the inclusion criteria, and a total of seven patients with meningitis/ventriculitis due to MDR A. baumannii , were included and treated with tigecycline ( 6 – 10 , 11 ). Moreover, we included one case of A. baumannii (AB) ventriculitis, with antibiograms for the isolates of AB only susceptible to tigecycline, which were treated with abscess clearance on a ventriculoscope combined with CVI and IVT tigecycline treatment.…”

Section: Introductionmentioning

confidence: 99%

Multidrug Resistant Brain Abscess Due to Acinetobacter baumannii Ventriculitis Cleared by Intraventricular and Intravenous Tigecycline Therapy: A Case Report and Review of Literature

et al. 2018

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Objective: Ventricular infection from multidrug-resistant (MDR) Acinetobacter baumannii (A. baumannii) is one of the most severe complications of craniotomy. However, the availability of effective therapeutic options for these infections is limited. Thus, this report aims to describe the efficacy of abscess clearance by intraventricular and intravenous tigecycline therapy in managing patients with multidrug-resistant A. baumannii ventriculitis after neurosurgery. Moreover, the current literature on the use of tigecycline therapy for these life-threatening infections is reviewed and summarized, and a treatment regimen based on the available data is proposed.Methods: A patient with multidrug-resistant A. baumannii ventriculitis was admitted in our hospital and was provided with a detailed therapeutic schedule. Tigecycline treatments for multidrug-resistant A. baumannii ventriculitis that were reported in the literature were also reviewed and summarized.Results: The patient in our hospital underwent abscess clearance on a ventriculoscope and was subsequently subjected to multi-route tigecycline therapy 14 days after the start of the continuous ventricular irrigation (CVI) tigecycline and 3 days after the intraventricular (IVT) tigecycline. The signs of ventriculitis disappeared, and the Acinetobacter cerebrospinal fluid (CSF) load steadily decreased until CSF sterilization. Literature review identified seven cases of ventricular infection from multidrug-resistant A. baumannii treated with tigecycline. In the eight cases, all patients were male adults (>18 years), with a mean age of 46.1 (range: 22–75) years. Meningitis/ventriculitis was secondary to neurosurgery procedures for the management of various central nervous system diseases in all cases. A good clinical outcome was achieved in all eight patients with multidrug-resistant A. baumannii meningitis/ventriculitis treated with CVI and/or IVT tigecycline, and any relevant complications were not observed.Conclusions: CVI and IVT tigecycline and IVT colistin could be considered as the first-line therapy in patients with ventricular infections from MDR/extreme drug-resistant A. baumannii. However, more studies should be conducted to confirm our observation.

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“…Microbiological efficacy at the end of the treatment was evident in 5 of 5 in monotherapy group, 6 of 7 tigecyclin+colistin group, 1 of 3 tigecycline+netilmicin group, 2 of 3 tigecycline+amikacin group and 2/2 of cases who received tigecycline+meropenem combination.Tigecycline monotherapy (Case 1-6): Microbiological response data at the EOT were available for five cases all of whom had CSF clearance. The only case who had not microbiological response data died on day 5 of tigecycline monotherapy.Tigecycline and colistin including therapy (Case 7-16): Seven cases had EOT CSF culture and six had bacteriological eradication (Case 9, 10,13,14,15,16). The case with bacteriological failure (case 8) died.Among three cases without EOT CSF culture data one (Case 11) died during therapy whereas two had EOT as well as one-month survival without any relapse (Case 7 and 12).Tigecycline and netilmicin including therapy (Case 16-19): Only one case (Case 18) had EOT CSF culture and had bacteriological eradication.…”

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confidence: 99%

“…In the presented study all strains were susceptible to tigecycline. Data regarding tigecycline in meningitis or A. baumannii meningitis is rare[6,7,16,[23][24][25][26][27][28]. To our knowledge, there are a few reports in which tigecycline is used to treat A. baumannii meningitis.…”

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confidence: 99%

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Tigecycline in the treatment of multidrug-resistant Acinetobacter baumannii meningitis: Results of the Ege study

Sıpahi

Mermer

Demırdal

et al. 2018

Clinical Neurology and Neurosurgery

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Successful treatment of postoperative multidrug-resistant Acinetobacter baumannii meningitis by tigecycline

Cited by 12 publications

References 11 publications

Emergence and Persistence of High-Risk Clones Among MDR and XDR A. baumannii at a Brazilian Teaching Hospital

Emergence and Persistence of High-Risk Clones Among MDR and XDR A. baumannii at a Brazilian Teaching Hospital

Multidrug Resistant Brain Abscess Due to Acinetobacter baumannii Ventriculitis Cleared by Intraventricular and Intravenous Tigecycline Therapy: A Case Report and Review of Literature

Tigecycline in the treatment of multidrug-resistant Acinetobacter baumannii meningitis: Results of the Ege study

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