Three Cases of Central Nervous System Infection Caused by Multi-Drug-Resistant Acinetobacter baumannii

In recent years, Acinetobacter baumannii has become an increasingly common nosocomial pathogen. It causes rare, but severe, central nervous system (CNS) infection, especially in patients undergoing neurosurgical procedures or with head trauma. Multi-drug-resistant A. baumannii (MDR-AB) has emerged as a pathogen causing CNS infection. We describe A. baumannii CNS infections seen during the last 5 years and focus on MDR-AB CNS infection. Seven patients were admitted to the neurosurgical intensive care unit with serious head injuries. Imipenem-susceptible A. baumannii was identified in all four cases seen from 2003 to 2006, whereas the three cases seen from 2007 to 2008 were MDR-AB CNS infections. Two cases of MDR-AB CNS infection were cured with intraventricular or intrathecal colistin without any side effects. Therefore, intraventricular or intrathecal colistin should be considered for MDR-AB CNS infection. Studies of the dose and duration of intraventricular and intrathecal administration are needed. (Korean J Med 2011;80:118-121)