Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2019; 7(24): 4342-4348
Published online Dec 26, 2019. doi: 10.12998/wjcc.v7.i24.4342
Postoperative multidrug-resistant Acinetobacter baumannii meningitis successfully treated with intravenous doxycycline and intraventricular gentamicin: A case report
Xia Wu, Lu Wang, Ying-Zi Ye, Hui Yu
Xia Wu, Ying-Zi Ye, Hui Yu, Department of Infectious Diseases, Children’s Hospital of Fudan University, Shanghai 201102, China
Lu Wang, Department of General Medicine, Children’s Hospital of Fudan University, Shanghai 201102, China
Author contributions: Wu X and Wang L contributed equally to this work; Wu X and Wang L designed and wrote the report; Ye YZ and Yu H reviewed the manuscript for its intellectual content and revised the entire work; all authors have read and approved the final manuscript.
Supported by The Shanghai Pujiang Program, No. 12PJ1401500.
Informed consent statement: The patient’s family members provided written informed consent.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hui Yu, PhD, Chief Doctor, Department of Infectious Diseases, Children’s Hospital of Fudan University, No. 399, Wanyuan Road, Shanghai 201102, China. yuhui4756@sina.com
Telephone: +86-21-64931184 Fax: +86-21-64931184
Received: September 18, 2019
Peer-review started: September 18, 2019
First decision: October 24, 2019
Revised: November 11, 2019
Accepted: November 23, 2019
Article in press: November 23, 2019
Published online: December 26, 2019
Abstract
BACKGROUND

Multidrug-resistant Acinetobacter baumannii (MDRAB) has emerged as an increasingly important pathogen that causes nosocomial meningitis. However, MDRAB-associated nosocomial meningitis is rarely reported in children.

CASE SUMMARY

We report the case of a 1-year-old girl with a choroid plexus papilloma, who developed postoperative nosocomial meningitis due to MDRAB. The bacterial strain was sensitive only to tigecycline and colistin, and showed varying degrees of resistance to penicillin, amikacin, ceftriaxone, cefixime, cefotaxime, ciprofloxacin, levofloxacin, gentamicin, meropenem, imipenem, and tobramycin. She was cured with intravenous doxycycline and intraventricular gentamicin treatment.

CONCLUSION

Doxycycline and gentamicin were shown to be effective and safe in the treatment of a pediatric case of MDRAB meningitis.

Keywords: Acinetobacter baumannii, Meningitis, Doxycycline, Gentamicin, Multidrug resistance, Case report

Core tip: Multidrug-resistant Acinetobacter baumannii (MDRAB) is a troublesome pathogen owing to multidrug resistance. Postoperative nosocomial meningitis due to Acinetobacter baumannii is rarely reported in children. Nosocomial meningitis due to MDRAB is fatal and its treatment is challenging because of the low blood-brain barrier permeability of antibiotic drugs. We describe the case of a child who developed post-neurosurgical meningitis due to MDRAB that was effectively treated by the combination of intravenous doxycycline and intraventricular gentamicin administration.