Jing Ye1, Lin-Hua Tan1, Zhi-Peng Shen2, Yun-Song Yu3, Deng-Ming Lai4, Jie Fan5,6,7, Qiang Shu8. 1. Department of Surgical ICU, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, 310052, China. 2. Department of Neurosurgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, 310052, China. 3. Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China. 4. Department of Neonatal Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, Zhejiang, China. 5. Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 6. Research and Development, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA. 7. McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA. 8. Department of Thoracic and Cardiovascular Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, No. 3333 Bin-Sheng Road, Bin-Jiang District, Hangzhou, 310052, China. shuqiang@zju.edu.cn.
Abstract
BACKGROUND: Increased meningitis caused by extensively drug-resistant bacillary presents a significant challenge in antibiotic selection. The aim of our study was to evaluate the efficacy and safety of polymyxin in the treatment of post-neurosurgical meningitis due to the extensively drug-resistant bacillary in children. METHODS: We performed a retrospective study on post-neurosurgical meningitis caused by the extensively drug-resistant bacillary in children, who were treated with polymyxin for ≥ 3 days. RESULTS: Among five post-neurosurgical meningitis cases that were included, the children were infected by Acinetobacter baumannii (n = 3), Klebsiella pneumonia (n = 1), and Pseudomonas aeruginosa (n = 1). The drug susceptibility test showed that they were extensively drug-resistant bacillary. Two patients received intravenous polymyxin E. Three children received intravenous combined with intraventricular injection of polymyxin B. One patient infected by Klebsiella pneumonia eventually died of septic shock. No serious adverse effects of polymyxin were observed. CONCLUSIONS: Polymyxin is a safe and effective therapy for post-neurosurgical, multidrug-resistant bacillary meningitis in children.
BACKGROUND: Increased meningitis caused by extensively drug-resistant bacillary presents a significant challenge in antibiotic selection. The aim of our study was to evaluate the efficacy and safety of polymyxin in the treatment of post-neurosurgical meningitis due to the extensively drug-resistant bacillary in children. METHODS: We performed a retrospective study on post-neurosurgical meningitis caused by the extensively drug-resistant bacillary in children, who were treated with polymyxin for ≥ 3 days. RESULTS: Among five post-neurosurgical meningitis cases that were included, the children were infected by Acinetobacter baumannii (n = 3), Klebsiella pneumonia (n = 1), and Pseudomonas aeruginosa (n = 1). The drug susceptibility test showed that they were extensively drug-resistant bacillary. Two patients received intravenous polymyxin E. Three children received intravenous combined with intraventricular injection of polymyxin B. One patient infected by Klebsiella pneumonia eventually died of septic shock. No serious adverse effects of polymyxin were observed. CONCLUSIONS: Polymyxin is a safe and effective therapy for post-neurosurgical, multidrug-resistant bacillary meningitis in children.
Entities:
Keywords:
Drug resistance; Meningitis; Neurosurgical procedures; Polymyxin
Authors: A Ondrusova; E Kalavsky; B Rudinsky; F P Freybergh; F Bauer; Jozef Miklosko; M Huttova; P Kisac; R Cauda Journal: Neuro Endocrinol Lett Date: 2007-06 Impact factor: 0.765