An Unusual Case of the Successful Treatment of Carbapenem-resistant Ventriculitis with Intravenous Colistin

Azizi Abu Bakar; Kamalanathan Palaniandy; Farizal Fadzil; Ainul Syahril Jaafar; Sanmugarajah Paramasvaran

doi:10.7759/cureus.7120

An Unusual Case of the Successful Treatment of Carbapenem-resistant Ventriculitis with Intravenous Colistin

Cureus. 2020 Feb 27;12(2):e7120. doi: 10.7759/cureus.7120.

Authors

Azizi Abu Bakar¹, Kamalanathan Palaniandy^{2

3}, Farizal Fadzil¹, Ainul Syahril Jaafar¹, Sanmugarajah Paramasvaran¹

Affiliations

¹ Neurosurgery, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, MYS.
² Neurosurgery, Fakulti Perubatan, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS.
³ Neurosurgery, Universiti Sains Malaysia, Kuala Lumpur, MYS.

Abstract

Ventriculitis is a well-documented complication of ventriculostomy, which is difficult to treat and is associated with high rates of mortality. There is a growing trend of resistance among many organisms, such as Acinetobacter baumannii, in particular, to most antibiotics with the exception of colistin. It is thought that colistin has poor blood-brain barrier penetration; therefore, in cases of ventriculitis, it is preferentially administered via the intrathecal or intraventricular route. These routes, in turn, risk introducing infections, which may perpetuate the problem. We report a case of multidrug-resistant Acinetobacter baumannii ventriculitis, which was treated successfully with intravenous colistin monotherapy.

Keywords: acinetobacter; carbapenem; colistin; ventriculitis.

Publication types

Case Reports