Oguz Reşat Sipahi1, Sinan Mermer2, Tuna Demirdal3, Aslıhan Candevir Ulu4, Pierre Fillatre5, Selin Bardak Ozcem6, Şafak Kaya7, Alper Şener8, Cemal Bulut9, Recep Tekin10, Hasip Kahraman11, Erkin Özgiray12, Taşkın Yurtseven12, Hilal Sipahi13, Bilgin Arda2, Hüsnü Pullukçu2, Meltem Taşbakan2, Tansu Yamazhan2, Sohret Aydemir14, Sercan Ulusoy2. 1. Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey. Electronic address: oguz.resat.sipahi@ege.edu.tr. 2. Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey. 3. Izmir Katip Celebi University, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey. 4. Cukurova University, Department of Infectious Diseases and Clinical Microbiology, Adana, Turkey. 5. Service de Maladies Infectieuses et Réanimation Médicale, Hôpital Pontchaillou, Rennes, France; CIC-Inserm-0203, Faculté de Médecine, Université Rennes 1, Rennes, France. 6. Dr Burhan Nalbantoglu State Hospital, Infectious Diseases Clinic, Near East University Hospital, Department of Infectious Diseases and Clinical Microbiology, Northern Cyprus, Nicosia, Cyprus. 7. Diyarbakir Gazi Yasargil Educational and Research Hospital, Infectious Diseases Clinic, Diyarbakir, Turkey. 8. Canakkale Onsekiz Mart University, Department of Infectious Diseases and Clinical Microbiology, Canakkale, Turkey. 9. Ankara Training and Research Hospital, Infectious Diseases Clinic, Ankara, Turkey. 10. Dicle University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Diyarbakir, Turkey. 11. Datca State Hospital, Mugla, Turkey. Electronic address: hasip.kahraman@saglik.gov.tr. 12. Ege University Faculty of Medicine, Department of Neurosurgery, Izmir, Turkey. 13. Bornova Public Health Directorate, Izmir, Turkey. 14. Ege University Faculty of Medicine, Department of Microbiology and Clinical Microbiology, Izmir, Turkey.
Abstract
OBJECTIVES: In this study we retrospectively reviewed A. baumannii meningitis cases treated with tigecycline including regimens and evaluated the efficacy of tigecycline in the therapy. PATIENTS AND METHODS: Study was performed in seven tertiary-care educational hospitals from five cities of Turkey and one center from France. We extracted data and outcomes of all adult (aged >18) patients with culture proven A. baumannii meningitis treated with tigecycline including antibiotic therapy until April 2016. RESULTS: A total of 23 patients (15 male and eight female) fulfilled our inclusion criteria. All Acinetobacter strains were carbapenem-resistant and susceptible to tigecycline. Six cases received tigecycline monotherapy while 17 received tigecycline including combination therapy (10 with colistin, 4 with netilmicin, 3 with amikacin, 4 with meropenem). Seven of 23 cases (30%) died during the tigecycline including therapy (1 in monotherapy, 4 in colistin, 2 in netilmicin, 1 amikacin, one case received tigecycline + netilmicin followed by tigecycline + colistin). Hence, overall end of treatment (EOT) success was 70%. However, since further 27% died due to additional nosocomial infections, overall clinical success (relieved symptoms at the EOT and one-month post-therapy survival without any relapse or reinfection) decreased to 43%. CONCLUSION: We conclude that tigecycline may be an alternative in the salvage treatment of nosocomial multidrug-resistant Acinetobacter spp. meningitis. Acinetobacter spp. Meningitis.
OBJECTIVES: In this study we retrospectively reviewed A. baumannii meningitis cases treated with tigecycline including regimens and evaluated the efficacy of tigecycline in the therapy. PATIENTS AND METHODS: Study was performed in seven tertiary-care educational hospitals from five cities of Turkey and one center from France. We extracted data and outcomes of all adult (aged >18) patients with culture proven A. baumannii meningitis treated with tigecycline including antibiotic therapy until April 2016. RESULTS: A total of 23 patients (15 male and eight female) fulfilled our inclusion criteria. All Acinetobacter strains were carbapenem-resistant and susceptible to tigecycline. Six cases received tigecycline monotherapy while 17 received tigecycline including combination therapy (10 with colistin, 4 with netilmicin, 3 with amikacin, 4 with meropenem). Seven of 23 cases (30%) died during the tigecycline including therapy (1 in monotherapy, 4 in colistin, 2 in netilmicin, 1 amikacin, one case received tigecycline + netilmicin followed by tigecycline + colistin). Hence, overall end of treatment (EOT) success was 70%. However, since further 27% died due to additional nosocomial infections, overall clinical success (relieved symptoms at the EOT and one-month post-therapy survival without any relapse or reinfection) decreased to 43%. CONCLUSION: We conclude that tigecycline may be an alternative in the salvage treatment of nosocomial multidrug-resistant Acinetobacter spp. meningitis. Acinetobacter spp. Meningitis.