Preliminary Analyze in VitroSusceptibilities of Antimicrobial Agentsand Antibiotic Treatment of AdultAcinetobacter meningitis in a MedicalCenter in Southern Taiwan

• Main Authors: Fang-Ting Chen, 陳芳婷
• Other Authors: Yen-Hsia Wen
• Format: Others
• Language: zh-TW
• Published: 2004
• Online Access: http://ndltd.ncl.edu.tw/handle/25583142256409662258

碩士 === 高雄醫學大學 === 藥學研究所碩士在職專班 === 92 === Previously, adult bacterial meningitis infection due to Acinetobacter species is uncommonIn recent years, the incidence of adult meningitis due to Acinetobacter species infection is increasing, especially in those patients with post-neurosurgical state. With rare exception, most of the adult cases of Acinetobacter species meningitis develop nosocomially. The pharmacological characteristics of Acinetobacter baumannii strains isolated from CSF of adult meningitis patients produced initial multi-resistant rapidly. These characteristics have caused a therapeutic challenge in the choice of initial empiric antibiotics or the use of antibiotics for maintenance therapy. We conduct this study from 1998 to 2003 totally eighteen patients, including twenty-one of the Acinetobacter strains isolated from CSF specimens of adult patients with meningitis to examine the antibiotics MIC data. The antibiotics used in this study are those that physicians usually used to treat adult bacterial Acinetobacter meningitis, and they include V ceftazidime, ceftriaxone, cefepime, imipenem, meropenem, aztreonam, ciprofloxacin and ampicillin/sulbactam. In this study,the results of in vitro activity show these antibiotics MIC data : imipenem MIC90% : 2, meropenem MIC90% : 4, cefepime MIC90% :>16, ceftriaxone >64, ceftazidime MIC90% :>128. From these datas, carbapenem are better choice than the third and fourth cephalosporins. Among the carbapenem (imipenem, meropenem ), imipenem had more tendency to induce seizure attack in therapeutic dose than meropenem. We suggest meropenem as empiric antibiotic to treat nosocomially-infected post-neurosurgical Acinetobacter meningitis. And then according to culture result choosing antibiotc for maintenance therapy. Despite the prognosis of other adult bacterial meningitis can be influenced by many factors. The result of this study, we do not find any significant factors including underlying diseases or clinical signs that increase patient’s mortality. This study may let the physicans have a better understanding in choosing a proper antibiotic for the management of adult Acinetobacter meningitis and improve the VI therapeutic result of this potentially fatal CNS infection. Besides, if the medical care after surgery procedure can be well controlled to prevent the Acinetobacter infection , that will save a lot of medical costs.