Recurrence of Postneurosurgical Central Nervous System Infection Caused by Acinetobacter baumannii in a Critically Ill Patient Treated With Cefiderocol. A Case Report
Abstract
Introduction: Acinetobacter baumannii (A. baumannii), a gram-negative bacterium, has become a significant hospital pathogen and the cause of severe nosocomial infections, especially in the intensive care unit (ICU). Bacterial meningitis is a recognized complication that can occur after neurosurgery, and the number of cases of multidrug-resistant (MDR) meningitis caused by A. baumannii is increasing. Critically ill patients in the ICU are at high risk, and the consequences are potentially fatal. Cefiderocol is a novel cephalosporin that can treat carbapenem-resistant infections in patients with limited treatment options. No clinical trials have investigated its capability to penetrate cerebrospinal fluid.
Case presentation: We describe the case of a 66-year-old man who was admitted to our neurointensive care unit after head trauma. On the CT scan performed on admission to the hospital, there was evidence of a subdural hematoma and subarachnoid and intraparenchymal hemorrhages in the frontotemporal region bilaterally. The patient then underwent a decompressive craniectomy. During hospitalization and following cranioplasty, the patient experienced a central nervous recurrence of carbapenem-resistant A. baumannii (CRAB) meningitis, which was treated with cefiderocol, resulting in a resolution of signs and symptoms of infection within a few days.
Conclusion: We present the first case of CRAB meningitis treated with this cefiderocol dosing regimen. In our case of postneurosurgical…
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