Meningitis Caused by Extensively Drug-Resistant Acinetobacter baumannii: Treatment Options and Factors Affecting Outcomes

Introduction In this study, we analyzed the clinical features of nosocomial meningitis caused by Acinetobacter baumannii ( A. baumannii ) to identify the factors affecting the outcome and compared the effectiveness of different therapeutic regimens. Methods The study analyzed patients diagnosed with healthcare-associated meningitis due to A. baumannii, and cases between 2017 and 2022 were included. Results We analyzed data from 52 patients. The 14-day mortality rate was 26.9%, and the 28-day mortality rate was 42.3%. Univariate analysis of factors affecting mortality showed that patients who did not receive intraventricular (IVT) treatment had a 5.6-fold higher risk of 14-day mortality and a 5.3-fold higher risk of 28-day mortality. In these patients, the higher risk of 14-day and 28-day mortality was also confirmed by the results of the multivariate analysis [p = 0.032, OR: 15.341; p = 0.039, OR: 9.273, respectively]. Whereas 10 of 26 patients (38.4%) who received only intravenous (IV) treatment achieved microbiological cure, 20 of 26 patients (76.9%) who received IV + IVT treatment achieved microbiological cure, and the difference was statistically significant (p = 0.005). There were no differences in 14-day and 28-day mortality rates between patients who received IVT colistin or amikacin in addition to IV therapy (p = 0.51, p = 0.63, respectively). Conclusion Our findings showed that adding IVT colistin or amikacin to IV therapy significantly decreases mortality and increases the microbiological cure.