Tigecycline in the treatment of multidrug-resistant Acinetobacter baumannii meningitis Results of the Ege study

Oguz Reşat Sipahi (1) , Sinan Mermer , Tuna Demirdal (2) , Aslihan Candevir Ulu (3) , Pierre Fillâtre (4, 5, 6) , Selin Bardak Ozcem , Şafak Kaya , Alper Şener (7) , Cemal Bulut , Recep Tekin , Hasip Kahraman , Erkin Özgiray , Taşkin Yurtseven , Hilal Sipahi , Bilgin Arda , Hüsnü Pullukçu , Meltem Taşbakan , Tansu Yamazhan , Sohret Aydemir , Sercan Ulusoy

1 Ege University [Izmir]
2 IKCU - Izmir Katip Celebi University
3 Cukurova University
4 UR Médecine - Université de Rennes - Faculté de Médecine
5 CIC - Centre d'Investigation Clinique [Rennes]
6 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
7 COMU - Çanakkale Onsekiz Mart University

Objectives - In this study we retrospectively reviewed A. baumannii meningitis cases treated with tigecycline including regimens and evaluated the efficacy of tigecycline in the therapy. Patients and methods - Study was performed in seven tertiary-care educational hospitals from five cities of Turkey and one center from France. We extracted data and outcomes of all adult (aged >18) patients with culture proven A. baumannii meningitis treated with tigecycline including antibiotic therapy until April 2016. Results - A total of 23 patients (15 male and eight female) fulfilled our inclusion criteria. All Acinetobacter strains were carbapenem-resistant and susceptible to tigecycline. Six cases received tigecycline monotherapy while 17 received tigecycline including combination therapy (10 with colistin, 4 with netilmicin, 3 with amikacin, 4 with meropenem). Seven of 23 cases (30%) died during the tigecycline including therapy (1 in monotherapy, 4 in colistin, 2 in netilmicin, 1 amikacin, one case received tigecycline + netilmicin followed by tigecycline + colistin). Hence, overall end of treatment (EOT) success was 70%. However, since further 27% died due to additional nosocomial infections, overall clinical success (relieved symptoms at the EOT and one-month post-therapy survival without any relapse or reinfection) decreased to 43%.Conclusion - We conclude that tigecycline may be an alternative in the salvage treatment of nosocomial multidrug-resistant Acinetobacter spp. meningitis. Acinetobacter spp. Meningitis.

Mots clés: Acinetobacter baumannii; Glycylcycline; Meningitis; Carbapenem-resistant; Multidrug resistant bacteria

Domaines: Maladies infectieuses; Médicaments

Oguz Reşat Sipahi, Sinan Mermer, Tuna Demirdal, Aslihan Candevir Ulu, Pierre Fillâtre, et al.. Tigecycline in the treatment of multidrug-resistant Acinetobacter baumannii meningitis Results of the Ege study. Clinical Neurology and Neurosurgery, 2018, 172, pp.31-38. ⟨10.1016/j.clineuro.2018.06.008⟩. ⟨hal-01833940v2⟩