Treatment of intracranial infection due to drug-resistant Acinetobacter Baumannii in neurosurgical ICU

Abstract

Objective To explore the treatment of intracranial infection due to drug-resistant Acinetobacter Baumannii in neurosurgical ICU.Methods The clinical data,including general status,primary diseases,infection sites,infection causes,drug sensitivity,therapeutic strategies and therapeutic effects,of 13 cases of intracranial infection due to drug-resistant Acinetobacter Baumannii in neurosurgical ICU (NSICU) of our hospital were retrospectively analyzed.Results The 13 cases,including 4 cascs of meningitis and 9 cases of ventriculitis,were all infected by drug-resistant Acinetobacter Baumannii.The causes of infection included 7 cases of CSF leakage,3 external ventricular drainage,2 retrograde hematogenous infection,and 1 lumbar cistern drainage.There were 4 cases of multi-drug resistant Acinetobacter Baumannii (MDRAB) and 9 cases of extensively drug resistant Acinetobacter Baumannii (XDRAB).The curative rate and mortality rate was 61.5％ and 38.5％,respectively.The curative rate of MDRAB was 100％,while the mortality rate of XDRAB was 55.6％.Conclusions The mortality rate of intracranial infection due to drug-resistant Acinetobacter Baumannii in NSICU was high.The main causes of infection were CSF leakage of incision and external ventricular drainage.Effective CSF drainage and reasonable choice of antibiotics were the keypoints for successful treatment.Combined treatment based on Meropenem for MDRAB,and treatment based on Polymyxin or Tigecycline combined with Sulbactam sodium for XDRAB could raise the curative rate. Key words: Neurosurgical intensive care unit; Acinetobacter Baumannii; Intracranial infection