Mortality rate in patients with nosocomial Acinetobacter meningitis from a Brazilian hospital

Tuon, Felipe Francisco; Penteado-Filho, Sergio R; Amarante, Diogo; Andrade, Marcio A; Borba, Luis A

doi:10.1016/S1413-8670(10)70090-8

The Brazilian Journal of Infectious Diseases

ISSN: 1413-8670

The Brazilian Journal of Infectious Diseases is the official publication of the Brazilian Society of Infectious Diseases (SBI). It aims to publish relevant articles in the broadest sense on all aspects of microbiology, infectious diseases and immune response to infectious agents.
The BJID is a bimonthly publication and one of the most influential journals in its field in Brazil and Latin America with a high impact factor. Since its inception it has garnered a growing share of the publishing market.

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The mean age of patients was 43 years (21 to 91) and 54.5% were male. All ANM cases occurred within 60 days of admission and the mean duration of illness was of 18.2 days. All cases were associated with previous neurosurgical procedures: elective surgery (27.2%), external shunt (54.4%) and emergency surgery due to trauma (18.1%). Imipenem resistance was observed in 40.9% of cases, but ampicillin/sulbactam resistance was lower (27.2%). The mortality rate of ANM patients was of 72.7%. The only risk factor associated with mortality was inappropriate therapy within five days after CSF collection. All patients who survived the meningitis episode had received appropriate therapy, in contrast to only 69.2% of those who did not survive (OR = 5.15; IC = 0.45-54.01).

Conclusions

The high mortality rate observed in our study suggests the need for aggressive empirical treatment with addition of drugs, including intrathecal therapy, where multi-resistant A. baumannii is endemic.

Keywords:

Acinetobacter

meningitis

Acinetobacter baumannii

neurosurgery

imipenem

ampicillin/ sulbactam

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