Successful treatment of multidrug-resistant Acinetobacter baumannii meningitis with intravenous colistin sulfomethate sodium.

Acinetobacter baumannii is an important emerging pathogen that causes nosocomial infections such as bacteremia, pneumonia, meningitis, urinary tract infections, and surgical-site infections. Acinetobacter meningitis is a severe nosocomial infection with an associated mortality of 20–27% that occurs predominantly secondary to invasive procedures [1, 2]. Carbapenems are considered the treatment of choice in Acinetobacter meningitis. However, since Acinetobacter baumannii may be resistant to a wide variety of antimicrobial agents [2, 3], the treatment of meningitis caused by multidrug-resistant organisms is a serious problem. The use of imipenem for Acinetobacter infections may promote the selection of imipenem-resistant strains, making the use of ampicillin-sulbactam useful [2]. However, some isolates are resistant to almost all available antimicrobial agents, including carbapenems and sulbactam [4, 5]. Polymyxins B and E are the only therapeutic options in these cases. This report describes a clinical case of meningitis caused by multidrug-resistant Acinetobacter baumannii susceptible only to polymyxins and treated successfully with intravenous colistin sulfomethate sodium.