Intraventricular polymyxin B for the treatment of neonatal meningo-ventriculitis caused by multi-resistant Acinetobacter baumannii--case report and review of literature.

Central nervous system infections due to multi- and pan-drug resistant Acinetobacter baumannii are an emerging problem in intensive care patients. A high mortality rate is seen in neonatal and central nervous system infections. Treatment can be prolonged and challenging. Polypeptide antibiotics remain one of the options but have poor cerebrospinal fluid (CSF) penetration. We present our experience of successfully treating pan-drug resistant A. baumannii neonatal meningitis and ventriculitis with intraventricular polymyxin B. This was administered by repeated ventricular punctures due to lack of consent for insertion of a ventricular reservoir.