Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Infection
Published in: Infection 5/2014

01-10-2014 | Review

Intrathecal/intraventricular colistin in external ventricular device-related infections by multi-drug resistant Gram negative bacteria: case reports and review

Authors: O. Bargiacchi, A. Rossati, P. Car, D. Brustia, R. Brondolo, F. Rosa, P. L. Garavelli, F. G. De Rosa

Published in: Infection | Issue 5/2014

Login to get access

Abstract

We report three cases of external ventricular derivation infections caused by multidrug-resistant Gram-negative rods and treated successfully with intraventricular colistin. The intrathecal or intraventricular use of colistin have been reported in more than 100 cases without any consensus on dosage, duration and type (monotherapy or combination therapy) of treatment. Based on our comprehensive review of the relevant literature relating to both clinical and pharmacokinetic data, we conclude that the intrathecal/intraventricular administration of colistin is a safe and effective option to treat central nervous system infections caused by multidrug-resistant Gram-negative bacteria.
Literature
1.
Jantzen JP. Prevention and treatment of intracranial hypertension. Best Pract Res Clin Anaesthesiol. 2007;21:517–38.PubMedCrossRef
2.
Gutiérrez-González R, Boto GR, Pérez-Zamarrón A. Cerebrospinal fluid diversion devices and infection. A comprehensive review. Eur J Clin Microbiol Infect Dis. 2012;31:889–97.PubMedCrossRef
3.
Kim JH, Desai NS, Ricci J, Stieg PE, Rosengart AJ, Härtl R, Fraser JF. Factors contributing to ventriculostomy infection. World Neurosurg. 2012;77:135–40.PubMedCrossRef
4.
Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD, Moreno R, Lipman J, Gomersall C, Sakr Y, Reinhart K. EPIC II group of investigators. International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009;302:2323–9.PubMedCrossRef
5.
Stenehjem E, Armstrong WS. Central nervous system device infections. Infect Dis Clin North Am. 2012;26:89–110.PubMedCrossRef
6.
Camacho EF, Boszczowski I, Basso M, Jeng BC, Freire MP, Guimarães T, Teixeira MJ, Costa SF. Infection rate and risk factors associated with infections related to external ventricular drain. Infection. 2011;39(1):47–51.PubMedCrossRef
7.
Falagas ME, Kasiakou SK. Colistin: the revival of polymyxins for the management of multidrug-resistant Gram-negative bacterial infections. Clin Infect Dis. 2005;40:1333–41.PubMedCrossRef
8.
9.
Kaplan SL, Patrick CC. Cefotaxime and aminoglycoside treatment of meningitis caused by Gram-negative enteric organisms. Pediatr Infect Dis J. 1990;9:810–4.PubMedCrossRef
10.
Fernandez-Viladrich P, Corbella X, Corral L, Tubau F, Mateu A. Successful treatment of ventriculitis due to carbapenem-resistant Acinetobacter baumannii with intraventricular colistin sulfomethate sodium. Clin Infect Dis. 1999;28:916–7.PubMedCrossRef
11.
12.
Benifla M, Zucker G, Cohen A, Alkan M. Successful treatment of acinetobacter meningitis with intrathecal polymyxin E. J Antimicrob Chemother. 2004;54:290–2.PubMedCrossRef
13.
Quinn AL, Parada JP, Belmares J, O’Keefe JP. Intrathecal colistin and sterilization of resistant Pseudomonas aeruginosa shunt infection. Ann Pharmacother. 2005;39:949–52.PubMedCrossRef
14.
Suárez Fernández C, Fernández-Viladrich P, Tubau F, Corral L, Mateu A. Intrathecal colistin treatment of central nervous system infections due to multi-resistant Acinetobacter baumannii. In: Program and Abstracts of 15th European Congress of Clinical Microbiology and Infectious Diseases. Abstract number 1134_02_277. Copenhagen
15.
Gump WC, Walsh JW. Intrathecal colistin for treatment of highly resistant pseudomonas ventriculitis. case report and review of the literature. J Neurosurg. 2005;102:915.PubMedCrossRef
16.
Kasiakou SK, Rafailidis PI, Liaropoulos K, Falagas ME. Cure of post-traumatic recurrent multiresistant Gram-negative rod meningitis with intraventricular colistin. J Infect. 2005;50:348–52.PubMedCrossRef
17.
Bukhary Z, Mahmood W, Al-Khani A, Al-Abdely HM. Treatment of nosocomial meningitis due to a multidrug resistant Acinetobacter baumannii with intraventricular colistin. Saudi Med J. 2005;26:656–8.PubMed
18.
Sueke H, Marsh H, Dhital A. Using intrathecal colistin for multidrug resistant shunt infection. Br J Neurosurg. 2005;19:51–2.PubMedCrossRef
19.
Berlana D, Llop JM, Fort E, Badia MB, Jódar R. Use of colistin in the treatment of multiple-drug-resistant Gram-negative infections. Am J Health Syst Pharm. 2005;62:39–47.PubMed
20.
Charra B, Hachimi A, Benslama A, Motaouakkil S. Intrathecal use of colistin. Ann Fr Anesth Reanim. 2006;25:215.PubMedCrossRef
21.
Karakitsos D, Paramythiotou E, Samonis G, Karabinis A. Is intraventricular colistin an effective and safe treatment for post-surgical ventriculitis in the intensive care unit? Acta Anaesthesiol Scand. 2006;50:1309–10.PubMedCrossRef
22.
Yagmur R, Esen F. Intrathecal colistin for treatment of Pseudomonas aeruginosa ventriculitis: report of a case with successful outcome. Crit Care. 2006;10:428.PubMedCrossRefPubMedCentral
23.
Ng J, Gosbell IB, Kelly JA, Boyle MJ, Ferguson JK. Cure of multiresistant Acinetobacter baumannii central nervous system infections with intraventricular or intrathecal colistin: case series and literature review. J Antimicrob Chemother. 2006;58:1078–81.PubMedCrossRef
24.
Al Shirawi N, Memish ZA, Cherfan A, Al Shimemeri A. Post-neurosurgical meningitis due to multidrug-resistant Acinetobacter baumanii treated with intrathecal colistin: case report and review of the literature. J Chemother. 2006;18:554–8.PubMedCrossRef
25.
Motaouakkil S, Charra B, Hachimi A, Nejmi H, Benslama A, Elmdaghri N, Belabbes H, Benbachir M. Colistin and rifampin in the treatment of nosocomial infections from multiresistant Acinetobacter baumannii. J Infect. 2006;53:274–8.PubMedCrossRef
26.
Schina M, Spyridi E, Daoudakis M, Mertzanos E, Korfias S. Successful treatment of multidrug-resistant Pseudomonas aeruginosa meningitis with intravenous and intrathecal colistin. Int J Infect Dis. 2006;10:178–9.PubMedCrossRef
27.
Metan G, Alp E, Aygen B, Sumerkan B. Acinetobacter baumannii meningitis in post-neurosurgical patients: clinical outcome and impact of carbapenem resistance. J Antimicrob Chemother. 2007;60:197–9.PubMedCrossRef
28.
Enfanto CM, Shin S. Treatment with intrathecal colistin of a resistant extended-spectrum [beta]-lactamase-producing Klebsiella pneumoniae in the cerebrospinal fluid. Infect Dis Clin Pract. 2007;15:274–7.CrossRef
29.
Ho YH, Wang LS, Chao HJ, Chang KC, Su CF. Successful treatment of meningitis caused by multidrug-resistant Acinetobacter baumannii with intravenous and intrathecal colistin. J Microbiol Immunol Infect. 2007;40:537–40.PubMed
30.
Paramythiotou E, Karakitsos D, Aggelopoulou H, Sioutos P, Samonis G, Karabinis A. Post-surgical meningitis due to multiresistant Acinetobacter baumannii. Effective treatment with intravenous and/or intraventricular colistin and therapeutic dilemmas. Med Mal Infect. 2007;37:124–5.PubMedCrossRef
31.
Lee CH, Tang YF, Su LH, Chien CC, Liu JW. Antimicrobial effects of varied combinations of meropenem, sulbactam, and colistin on a multidrug-resistant Acinetobacter baumannii isolate that caused meningitis and bacteremia. Microb Drug Resist. 2008;14:233–7.PubMedCrossRef
32.
Rodríguez Guardado A, Blanco A, Asensi V, Pérez F, Rial JC, Pintado V, Bustillo E, Lantero M, Tenza E, Alvarez M, Maradona JA, Cartón JA. Multidrug-resistant Acinetobacter meningitis in neurosurgical patients with intraventricular catheters: assessment of different treatments. J Antimicrob Chemother. 2008;61:908–13.PubMedCrossRef
33.
Hachimi A, Charra B, Benslama A, Motaouakkil S. Intrathecal use of amikacin and colistin. Ann Fr Anesth Reanim. 2008;27:113–4.PubMedCrossRef
34.
Rodriguez CH, Bombicino K, Granados G, Nastro M, Vay C, Famiglietti A. Selection of colistin-resistant Acinetobacter baumannii isolates in post neurosurgical meningitis in an intensive care unit with high presence of heteroresistance to colistin. Diagn Microbiol Infect Dis. 2009;65:188–91.PubMedCrossRef
35.
López-Alvarez B, Martín-Láez R, Fariñas MC, Paternina-Vidal B, García-Palomo JD, Vázquez-Barquero A. Multidrug-resistant Acinetobacter baumannii ventriculitis: successful treatment with intraventricular colistin. Acta Neurochir (Wien). 2009;151:1465–72.CrossRef
36.
Dalgic N, Ceylan Y, Sancar M, Telhan L, Kafadar I, Cavusoglu H, Ceylan O, Hasim O. Successful treatment of multidrug-resistant Acinetobacter baumannii ventriculitis with intravenous and intraventricular colistin. Ann Trop Paediatr. 2009;29:141–7.PubMedCrossRef
37.
Baiocchi M, Catena V, Zago S, Badolati L, Baccarin M. Intrathecal colistin for treatment of multidrug resistant (MDR) Pseudomonas aeruginosa after eurosurgical ventriculitis. Infez Med. 2010;18:182–6.PubMed
38.
De Pascale G, Pompucci A, Maviglia R, Spanu T, Bello G, Mangiola A, Scoppettuolo G. Successful treatment of multidrug-resistant Acinetobacter baumannii ventriculitis with intrathecal and intravenous colistin. Minerva Anestesiol. 2010;76:957–60.PubMed
39.
Khawcharoenporn T, Apisarnthanarak A, Mundy LM. Intrathecal colistin for drug-resistant Acinetobacter baumannii central nervous system infection: a case series and systematic review. Clin Microbiol Infect. 2010;16:888–94.PubMedCrossRef
40.
Cascio A, Conti A, Sinardi L, Iaria C, Angileri FF, Stassi G, David T, Versaci A, Iaria M, David A. Post-neurosurgical multidrug-resistant Acinetobacter baumannii meningitis successfully treated with intrathecal colistin. A new case and a systematic review of the literature. Int J Infect Dis. 2010;14:e572–9.PubMedCrossRef
41.
Kim K, Kang HS, Sohn CH, Oh BM. Cauda equina syndrome misdiagnosed as aggravated hydrocephalus: neurological complication of intrathecal colistin in post-surgical meningitis. Acta Neurochir (Wien). 2011;153:425–7.CrossRef
42.
Ozdemir H, Tapisiz A, Ciftçi E, Ince E, Mokhtari H, Güriz H, Aysev AD, Doğru U. Successful treatment of three children with post-neurosurgical multidrug-resistant Acinetobacter baumannii meningitis. Infection. 2010;38:241–4.PubMedCrossRef
43.
Razmkon A, Mehrafshan A, Bakhtazad A. Management of post-neurosurgical Acinetobacter infections: experiences obtained during an outbreak. Acta Neurochir (Wien). 2011;153:435–6.CrossRef
44.
Patel JA, Pacheco SM, Postelnick M, Sutton S. Prolonged triple therapy for persistent multidrug-resistant Acinetobacter baumannii ventriculitis. Am J Health Syst Pharm. 2011;68:1527–31.PubMedCrossRef
45.
Saleem AF, Shah MS, Shaikh AS, Mir F, Zaidi AK. Acinetobacter species meningitis in children: a case series from Karachi. Pak J Infect Dev Ctries. 2011;5:809–14.
46.
Alaoui SY, Nejmi SE, Chakir AA, Hmamouchi B, Chlilek A. Intraventricular colistin use in neonatal meningitis caused by Acinetobacter baumanii. Ann Fr Anesth Reanim. 2011;30:854–5.PubMedCrossRef
47.
Wang JH, Lin PC, Chou CH, Ho CM, Lin KH, Tsai CT, Wang JH, Chi CY, Ho MW. Intraventricular antimicrobial therapy in postneurosurgical Gram-negative bacillary meningitis or ventriculitis: a hospital-based retrospective study. J Microbiol Immunol Infect. 2012. doi:10.​1016/​j.​jmii.​2012.​08.​028.
48.
Imberti R, Cusato M, Accetta G, Marinò V, Procaccio F, Del Gaudio A, Iotti GA, Regazzi M. Pharmacokinetics of colistin in cerebrospinal fluid after intraventricular administration of colistin methanesulfonate. Antimicrob Agents Chemother. 2012;56:4416–21.PubMedCrossRefPubMedCentral
49.
Ziaka M, Markantonis SL, Fousteri M, Zygoulis P, Panidis D, Karvouniaris M, Makris D, Zakynthinos E. Combined intravenous and intraventricular administration of colistin methanesulfonate in critically ill patients with central nervous system infection. Antimicrob Agents Chemother. 2013;57:1938–40.PubMedCrossRefPubMedCentral
50.
Karaiskos I, Galani L, Baziaka F, Katsouda E, Ioannidis I, Andreou A, Paskalis H, Giamarellou H. Successful treatment of extensively drug-resistant Acinetobacter baumannii ventriculitis and meningitis with intraventricular colistin after application of a loading dose: a case series. Int J Antimicrob Agents. 2013;41:480–3.PubMedCrossRef
51.
Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM, Whitley RJ. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis. 2004;39:1267–84.PubMedCrossRef
52.
Tumbarello M, Viale P, Viscoli C, Trecarichi EM, Tumietto F, Marchese A, Spanu T, Ambretti S, Ginocchio F, Cristini F, Losito AR, Tedeschi S, Cauda R, Bassetti M. Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae: importance of combination therapy. Clin Infect Dis. 2012;55:943–50.PubMedCrossRef
53.
Liang W, Liu XF, Huang J, Zhu DM, Li J, Zhang J. Activities of colistin- and minocycline-based combinations against extensive drug resistant Acinetobacter baumannii isolates from intensive care unit patients. BMC Infect Dis. 2011;27:109.CrossRef
54.
Tan TY, Lim TP, Lee WH, Sasikala S, Hsu LY, Kwa AL. In vitro antibiotic synergy in extensively drug-resistant Acinetobacter baumannii: the effect of testing by time-kill, checkerboard, and E test methods. Antimicrob Agents Chemother. 2011;55:436–8.PubMedCrossRefPubMedCentral
55.
Tascini C, Gemignani G, Ferranti S, Tagliaferri E, Leonildi A, Lucarini A, Menichetti F. Microbiological activity and clinical efficacy of a colistin and rifampin combination in multidrug-resistant Pseudomonas aeruginosa infections. J Chemother. 2004;16:282–7.PubMedCrossRef
56.
Tascini C, Tagliaferri E, Giani T, Leonildi A, Flammini S, Casini B, Lewis R, Ferranti S, Rossolini GM, Menichetti F. Synergistic activity of colistin plus rifampin against colistin-resistant KPC-producing Klebsiella pneumoniae. Antimicrob Agents Chemother. 2013;57:3990–3.PubMedCrossRefPubMedCentral
57.
Jiménez-Mejías ME, Pichardo-Guerrero C, Márquez-Rivas FJ, Martín-Lozano D, Prados T, Pachón J. Cerebrospinal fluid penetration and pharmacokinetic/pharmacodynamic parameters of intravenously administered colistin in a case of multidrug-resistant Acinetobacter baumannii meningitis. Eur J Clin Microbiol Infect Dis. 2002;21:212–4.PubMedCrossRef
58.
Plachouras D, Karvanen M, Friberg LE, Papadomichelakis E, Antoniadou A, Tsangaris I, Karaiskos I, Poulakou G, Kontopidou F, Armaganidis A, Cars O, Giamarellou H. Population pharmacokinetic analysis of colistin methanesulfonate and colistin after intravenous administration in critically ill patients with infections caused by gram-negative bacteria. Antimicrob Agents Chemother. 2009;53:3430–6.PubMedCrossRefPubMedCentral
59.
Everett ED, Strausbaugh LJ. Antimicrobial agents and the central nervous system. Neurosurgery. 1980;6:691–714.PubMedCrossRef
60.
Jiménez-Mejías ME, Becerril B, Márquez-Rivas FJ, Pichardo C, Cuberos L, Pachón J. Successful treatment of multidrug-resistant Acinetobacter baumannii meningitis with intravenous colistin sulfomethate sodium. Eur J Clin Microbiol Infect Dis. 2000;19:970–1.PubMedCrossRef
61.
Antachopoulos C, Karvanen M, Iosifidis E, Jansson B, Plachouras D, Cars O, Roilides E. Serum and cerebrospinal fluid levels of colistin in pediatric patients. Antimicrob Agents Chemother. 2010;54:3985–7.PubMedCrossRefPubMedCentral
62.
Markantonis SL, Markou N, Fousteri M, Sakellaridis N, Karatzas S, Alamanos I, Dimopoulou E, Baltopoulos G. Penetration of colistin into cerebrospinal fluid. Antimicrob Agents Chemother. 2009;53:4907–10.PubMedCrossRefPubMedCentral
Metadata
Title
Intrathecal/intraventricular colistin in external ventricular device-related infections by multi-drug resistant Gram negative bacteria: case reports and review
Authors
O. Bargiacchi
A. Rossati
P. Car
D. Brustia
R. Brondolo
F. Rosa
P. L. Garavelli
F. G. De Rosa
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 5/2014
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-014-0618-0

Other articles of this Issue 5/2014

Infection 5/2014 Go to the issue

Case Report

A novel case of chronic conjunctivitis in a 58-year-old woman caused by Raoultella

Clinical and Epidemiological Study

Infective endocarditis in Rio de Janeiro, Brazil: a 5-year experience at two teaching hospitals

Review

Recommendations for the management of acute hepatitis B: position paper of the Italian Society for the Study of Infectious and Tropical Diseases (SIMIT)

Clinical and Epidemiological Study

Recurrent outbreaks of Serratia marcescens among neonates and infants at a pediatric department: an outbreak analysis

Clinical and Epidemiological Study

The role of colonization pressure in the dissemination of colistin or tigecycline resistant KPC-producing Klebsiella pneumoniae in critically ill patients

Images in Infection

Not only fever and palmoplantar vesicular eruption
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits