Intraventricular treatment of paediatric meningitis due to extensively drug-resistant Gram-negative bacteria: two case reports and review of the literature

Abstract

Nosocomial meningitis caused by Gram-negative bacteria is associated with increasingly common neurosurgical procedures in children, with an increase in incidence recently reported. These infections are associated with an increased risk of mortality, prolonged hospitalisation, and increased costs. In this report, we describe two paediatric cases with central nervous system infections caused by extensively drug-resistant Gram-negative bacteria that were successfully treated with intraventricular colistin. To the best of our knowledge, this is the first comprehensive review and discussion of intraventricular antimicrobial therapy in a paediatric population. Based on our comprehensive review of the relevant literature, it appears that intraventricular administration of colistin may be a promising and effective option in the treatment of central nervous system infections in children who do not respond to other treatment options.

Keywords:

• Intraventricular treatment
• Nosocomial meningitis
• Children
• Neurosurgery
• Gram-negative bacterial infections
• Drug resistance
• Bacterial
• Colistin

Disclosure of interest

The authors report no conflict of interest.

Additional information

Notes on contributors

Melis Deniz

Melis Deniz, MD is a research fellow of Pediatric Infectious Diseases department in the Faculty of Medicine in Gazi University, Ankara.

Anıl Tapısız

Anıl Tapısız, MD is a professor of Pediatric Infectious Diseases department in the Faculty of Medicine in Gazi University, Ankara.

Alp Özgün Börcek

Alp Ozgun Borcek, MD is an associate professor of pediatric neurosurgery in the Faculty of Medicine in Gazi University, Ankara.