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Báo cáo khoa học: " Intrathecal colistin for treatment of Pseudomonas aeruginosa ventriculitis: report of a case with successful outcome"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Intrathecal colistin for treatment of Pseudomonas aeruginosa ventriculitis: report of a case with successful outcome. | Available online http ccforum.eom content 10 6 428 Letter Intrathecal colistin for treatment of Pseudomonas aeruginosa ventriculitis report of a case with successful outcome Rezzan Yagmur1 and Figen Esen2 1 Hisar Intercontinental Hospital Anesthesiology and ICU Istanbul Turkey 2Istanbul University Medical Faculty Department of Anesthesiology and ICU Istanbul Turkey Corresponding author Rezzan Yagmur ryagmur@hisarhospital.com Published 28 December 2006 Critical Care 2006 10 428 doi 10.1186 cc5088 This article is online at http ccforum.com content 10 6 428 2006 BioMed Central Ltd Infection of the ventricular cavity and of the ependymal lining is most often iatrogenic in origin being a complication of a shunting procedure or of intrathecal chemotherapy. The emergence of multidrug-resistant Gram-negative bacteria and the lack of new antibiotics to combat them have led to the revival of polymyxins an old class of cationic cyclic polypeptide antibiotics. Polymyxin B and polymyxin E colistin are the two polymyxins used in clinical practice. Colistin is a polymyxin-type antibiotic disrupting the structure of Gram-negative organisms cell membranes rarely used parenterally because it has nephrotoxic side effects. The polymyxins are active against selected Gram-negative bacteria including Acinetobacter species Pseudomonas aeruginosa Klebsiella species and Enterobacter species 1 . We report a case of multidrugresistant P. aeruginosa ventriculitis treated successfully with intrathecal colistin. A 16-year-old boy who had a car accident required hospitalization and underwent multiple surgeries including decompressive craniectomy and placement of ventriculoperitoneal and ventriculoatrial shunts. The ventriculoatrial shunt subsequently became colonized with P. aeruginosa and was removed and was then replaced with an external ventricular drainage catheter. Cerebrospinal fluid cultures demonstrated multiresistant P. aeruginosa. Intravenous amikacin was initiated initially but there .