Núñez M L, Martínez-Toldos M C, Bru M, Simarro E, Segovia M, Ruiz J
Laboratory of Microbiology, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
Scand J Infect Dis. 1998;30(4):421-3. doi: 10.1080/00365549850160774.
A case is reported of a patient who developed Acinetobacter meningitis after an external ventricular drainage system had been fitted for control of intracranial pressure. During the process, nine strains of Acinetobacter isolated from her cerebrospinal fluid were indistinguishable by analysis of total genomic DNA by pulse-field gel electrophoresis. The first eight strains were sensitive to meropenem and imipenem (MICs < 1 g/l). The MIC of the last one, which had been recovered after 32 days during two courses of treatment with meropenem, increased to > 32 g/l for meropenem, while with imipenem the increase was minimal (MIC = 1.5 g/l). The microorganism persisted in the central nervous system despite the administration of different antimicrobials, including intraventricular aminoglycosides and six changes in the external ventricular system. The patient died 68 days after admission to the intensive care unit from bilateral cerebral ischemic lesions, intraventricular hemorrhage and cerebral edema with endocraneal hypertension, the Acinetobacter ventriculitis also contributing to this state.
报道了1例患者，其在安装用于控制颅内压的外部脑室引流系统后发生不动杆菌性脑膜炎。在此过程中，通过脉冲场凝胶电泳分析其脑脊液中分离出的9株不动杆菌的全基因组DNA，结果显示无法区分这些菌株。前8株菌株对美罗培南和亚胺培南敏感（MIC<1μg/ml）。最后1株菌株是在接受两个疗程美罗培南治疗32天后分离得到的，其对美罗培南的MIC增加至>32μg/ml，而对亚胺培南的增加幅度最小（MIC=1.5μg/ml）。尽管使用了包括脑室内氨基糖苷类药物在内的不同抗菌药物，且外部脑室系统更换了6次，但该微生物仍在中枢神经系统持续存在。患者在入住重症监护病房68天后因双侧脑缺血性病变、脑室内出血和伴有颅内高压的脑水肿死亡，不动杆菌性脑室炎也是导致这种情况的原因之一。
