AUTHOR=Pandey Sajan , Li Lei , Deng Xian Yu , Cui Da Ming , Gao Liang 

TITLE=Outcome Following the Treatment of Ventriculitis Caused by Multi/Extensive Drug Resistance Gram Negative Bacilli; Acinetobacter baumannii and Klebsiella pneumonia

JOURNAL=Frontiers in Neurology

VOLUME=Volume 9 - 2018

YEAR=2019

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2018.01174

DOI=10.3389/fneur.2018.01174

ISSN=1664-2295

ABSTRACT=<p><bold>Introduction:</bold> CNS ventriculitis is a serious complication following an intracranial insult that demands immediate treatment with broad-spectrum antibiotics in a critical care setting. Infections due to multi/extensive drug resistance (MDR/XDR) microorganisms are very challenging, which may demand an additional approach to the ongoing practice; intravenous and intraventricular administration of antibiotics.</p><p><bold>Aim:</bold> To study the efficacy and safety of thorough ventricular irrigation followed by daily intraventricular antibiotic administration in patients with MDR/XDR ventriculitis.</p><p><bold>Materials and Methods:</bold> A retrospective analysis was done on 19 inpatients with ventriculitis caused by <italic>Acinetobacter baumannii</italic> (AB) or <italic>Klebsiella pneumonia</italic> (KP), at Shanghai Tenth People's Hospital from January 2016 to October 2017. We reviewed our experience; the role of thorough ventricular irrigation with Colistin mixed normal saline, followed by intraventricular Colistin therapy. Treatment outcomes were evaluated based on the clinical symptoms, Cerebro-Spinal Fluid (CSF) culture, laboratory findings and complications.</p><p><bold>Results:</bold> A total of 19 patients were included (15 males and 4 females), with a mean age in years of 51, which ranged from 18–67. Fourteen patients had <italic>Acinetobacter baumannii</italic> (AB) and 5 had <italic>Klebsiella pneumoniae</italic> (KP). The average CSF sterilization period following ventricular irrigation and intraventricular Colistin was 6 days. Sixteen patients (84%) were cured, and 3 patients (15%) died during the course of the treatment.</p><p><bold>Conclusion:</bold> In addition to Intraventricular Colistin, thorough ventricular irrigation could increase the cure rate up to 84% in patients suffering from MDR/XDR CNS ventriculitis.</p>