Healthcare-associated bacterial meningitis

被引：16

作者：

Laxmi S. ^{[1
]}

Tunkel A.R. ^{[1
]}

机构：

[1] Department of Medicine, Monmouth Medical Center, Long Branch, NJ 07740

来源：

Current Infectious Disease Reports | 2011年 / 13卷 / 4期

关键词：

Antibiotic-impregnated catheters; Antimicrobial agents; Bacterial meningitis; Carbapenems; Cephalosporins; Cerebrospinal fluid; Cerebrospinal fluid shunt; Colistin; Craniotomy; Gram-negative bacilli; Head trauma; Healthcare-associated infections; Intraventricular antibiotics; Lumbar puncture; Meningitis; Neuroimaging; Nosocomial infections; Prevention of infection; Skull fracture; Staphylococci; Vancomycin; Ventriculostomy;

D O I：

10.1007/s11908-011-0190-z

中图分类号：

学科分类号：

摘要：

Healthcare-associated bacterial meningitis may occur after neurosurgical procedures, head trauma, and following placement of external or internal ventricular catheters. The likely microorganisms that cause meningitis in this setting (ie, staphylococci and gram-negative bacilli) are different from those that cause meningitis in the community setting. Any clinical suspicion of healthcare-associated bacterial meningitis should prompt a diagnostic evaluation (neuroimaging and cerebrospinal fluid analysis) and appropriate management. Empiric antimicrobial therapy should be directed toward the likely infecting pathogen; based upon clinical response, intraventricular administration of specific agents may be required. With the emergence of resistant gram-negative bacilli (especially Acinetobacter baumannii) that may cause healthcare- associated meningitis, empiric therapy with a carbapenem, with or without an aminoglycoside administered by the intraventricular or intrathecal route, is recommended; colistin (given intravenously and/or intraventricularly) can be used if the organism is subsequently found to be resistant to carbapenems. © 2011 Springer Science+Business Media, LLC.

引用

页码：367 / 373

页数：6

共 41 条

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