scholarly journals Intrathecal Colistin and Intravenous Fosfomycin as a combination therapy for the treatment of Acinetobacter baumannii Ventriculitis and meningitis: a case report from Nepal

2021 ◽  
Vol 18 (4) ◽  
pp. 39-43
Author(s):  
Bikash Khadka ◽  
Saroj Poudel
Keyword(s):  
Central Nervous System ◽  
Drug Resistance ◽  
Nervous System ◽  
Acinetobacter Baumannii ◽  
Central Nervous System Infection ◽  
Multi Drug Resistance ◽  
Intraventricular Administration ◽  
Successful Management ◽  
Initial Regimen ◽  
Cns Penetration

Treatment of central nervous system infection may be troublesome due to multi-drug resistance. Colistin is less successful as a treatment option due to poor CNS penetration when used intravenously. We present the successful management of a case with ventriculitis and meningitis due to MDR Acinetobacter baumannii species with the combined intraventricular administration of colistin and IV fosfomycin after the initial regimen of colistin given alone through both IVT and IV routes had failed.

Impact of Intracranial Pressure Monitor Prophylaxis on Central Nervous System Infections and Bacterial Multi-Drug Resistance

2008 ◽  
Vol 9 (5) ◽  
pp. 503-508 ◽  
Author(s):  
Nathaniel F. Stoikes ◽  
Louis J. Magnotti ◽  
Timothy M. Hodges ◽  
Jordan A. Weinberg ◽  
Thomas J. Schroeppel ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Drug Resistance ◽  
Nervous System ◽  
Intracranial Pressure ◽  
Multi Drug Resistance ◽  
Central Nervous System Infections ◽  
Pressure Monitor

scholarly journals A Dual Case of Peritonitis and Central Nervous System Infection Caused by Nutritionally Variant Streptococcal Species

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Sussi Vivar ◽  
Jennifer E. Girotto ◽  
Thomas S. Murray
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Potential Role ◽  
Central Nervous System Infection ◽  
Shunt Revision ◽  
Cns Involvement ◽  
Invasive Infections ◽  
Streptococcal Species ◽  
Cns Penetration ◽  
Dual Case

Nutritional variant streptococci (NVS) are difficult to identify bacteria that can cause invasive infections such as endocarditis and meningitis. NVS as a cause of peritonitis has not been routinely described. This case of NVS as the etiology of peritonitis associated with previous neurosurgery and ventriculoperitoneal (VP) shunt revision demonstrates its potential role as a significant pathogen in patients with peritonitis and VP shunts. Therapy consists of vancomycin plus a second agent but since there are no standards for susceptibility testing, clinical response remains the standard for determining the efficacy of treatment. When there is central nervous system (CNS) involvement it is important to include drugs with appropriate CNS penetration.

scholarly journals Multi-drug resistance gene (MDR1) and opioid analgesia in horses

2006 ◽  
Vol 36 (1) ◽  
pp. 330-335 ◽  
Author(s):  
Cláudio Corrêa Natalini ◽  
Anderson Fávaro da Cunha ◽  
Renata Lehn Linardi
Keyword(s):  
Central Nervous System ◽  
Drug Resistance ◽  
Nervous System ◽  
Resistance Gene ◽  
Opioid Analgesic ◽  
Mdr1 Gene ◽  
Neuronal Uptake ◽  
Multi Drug Resistance ◽  
Drug Resistance Gene ◽  
The Central Nervous System

Opioid absorption in the intestinal tract as well as its effects in the central nervous system is modulated by the P-glycoprotein (P-gp) encoded in the Multi-drug Resistance gene (MDR1) also named ATP-binding cassete, subfamily B, member 1 (ABCB1). This MDR1 gene acts as a selective pump. The expression of this protein in humans and rodents inhibits cellular uptake of substrate opioids. The presence of the intestinal iso-enzyme CYP3A4 associated with MDR1 gene decreases the opioid analgesic activity due to an increase in intestinal metabolism, with a predicted intestinal first pass extraction around 20% which significantly influences the oral availability of opioids. In the central nervous system, P-gp expression decreases opioid neuronal uptake diminishing the analgesic effects. It is unknown if horses have the MDR1 gene and P-gp and what are the effects on opioid absorption, metabolism, and analgesia. Identifying the MDR1 gene and P-gp status in horses is of great importance in order to better understand opioid pharmacologic effects in horses.

scholarly journals Combined Intravenous and Intraventricular Administration of Colistin Methanesulfonate in Critically Ill Patients with Central Nervous System Infection

2013 ◽  
Vol 57 (4) ◽  
pp. 1938-1940 ◽  
Author(s):  
Mairi Ziaka ◽  
Sophia L. Markantonis ◽  
Marizoza Fousteri ◽  
Paris Zygoulis ◽  
Dimitris Panidis ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Critically Ill ◽  
Intravenous Administration ◽  
Critically Ill Patients ◽  
External Ventricular Drain ◽  
Central Nervous System Infection ◽  
Intraventricular Administration ◽  
Colistin Methanesulfonate

ABSTRACTColistin pharmacokinetics were prospectively studied after intravenous administration of colistin methanesulphonate in critically ill patients without central nervous system infection (controls,n= 5) and in patients with external ventricular drain-associated ventriculitis after intravenous administration (EVDViv,n= 3) or combined intravenous/intraventricular administration (EVDVcomb,n= 4). Cerebrospinal fluid (CSF)/serum colistin concentration ratios were higher in EVDViv than in control patients (11% versus 7%,P≤ 0.05) and in EVDVcomb compared to all other patients (P< 0.0001). CSF colistin concentrations above the MIC of 0.5 μg/ml were achieved only in EVDVcomb patients.

Infection of a Shunt by Mycobacterium fortuitum: Case Report

Neurosurgery ◽  
1991 ◽  
Vol 29 (3) ◽  
pp. 472-474 ◽  
Author(s):  
Kwan-Hon Chan ◽  
Kirpal S. Mann ◽  
W. H. Seto
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Case Report ◽  
Obstructive Hydrocephalus ◽  
Central Nervous System Infection ◽  
Shunt Infection ◽  
Mycobacterium Fortuitum ◽  
Intraventricular Administration ◽  
Ventriculoatrial Shunt ◽  
Pertinent Literature

Abstract Mycobacterium fortuitum is a rare cause of central nervous system infection: however, shunt infection caused by this organism has not been reported. We report a case of shunt infection subsequent to insertion of a ventriculoatrial shunt for obstructive hydrocephalus caused by a cerebellar hematoma. The shunt infection was controlled by removal of the shunt and a combination of systemic and intraventricular administration of amikacin, and oral administration of ofloxacin. The case is discussed and the pertinent literature reviewed.

scholarly journals Spinal arachnoiditis followed by intrathecal tigecycline therapy for central nervous system infection by extremely drug-resistant Acinetobacter baumannii

2020 ◽  
Vol 48 (7) ◽  
pp. 030006052092040 ◽  
Author(s):  
Liang-Ming Li ◽  
Wen-Jian Zheng ◽  
Shang-Wen Shi
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Acinetobacter Baumannii ◽  
Adverse Reactions ◽  
Central Nervous System Infection ◽  
Drug Resistant ◽  
Extensively Drug Resistant ◽  
Spinal Arachnoiditis ◽  
Safe Dose

In prior research, intrathecal tigecycline was successfully used to treat central nervous system infection by extensively drug-resistant Acinetobacter baumannii. However, little is known about its safe dose and adverse reactions. This study reports the case of a 28-year-old male patient who was diagnosed with central nervous system infection by extensively drug-resistant A. baumannii after the removal of a ventriculoperitoneal shunt. Intravenous and intrathecal tigecycline were administrated simultaneously. Spinal arachnoiditis was discovered after nine doses of intrathecal tigecycline. Spinal arachnoiditis was resolved after discontinuation of the antibiotic. This is the first report of an adverse reaction to intrathecal tigecycline. The case was complicated by spinal arachnoiditis, which obstructed the assessment of cerebrospinal fluid. The appropriate dose and administration schedule of intrathecal tigecycline remain to be determined.

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