Therapeutic Effect Of Intravenous Infusion Combined With Intraventricular Injection Of Tigecyciline On Multidrug-resistant/entensively Drug-resistant Acinetobacter Baumannii Intracranial Infection After Neurosuegery

Background:Intracranial infection is one of the serious complications after neurosurgery,it has a very important impact on the prognosis of patients.With the widespread use of antibiotics and the constant variation of bacterial resistance,Multidrug-resistant and Extensively drug-resistant(MDR,XDR)Acinetobacter baumannⅱ(Ab)has emerged globally.The number of intracranial infections after neurosurgery has also been rising,bringing a heavy burden to patients and society.Tigecycline,a new antibiotic,have a good therapeutic effect on MDR/XDR Ab,however,its concentration in the cerebrospinal fluid is very low due to its large apparent volume of distribution and the presence of the blood-brain barrier,therefore,there are some certain limitations in clinical application.The purpose of this study is to investigate the efficacy of Intravenous drip(Ⅳ)combined with Intraventri cularly injection(ⅣT)tigecycline in the treatment of MDR/XDR Ab intracranial infection after neurosurgery.MethodsThis retrospective study was conducted from January 2012 to January 2018 in Qianfoshan Hospital of Shandong Proⅵnce and 18 cases were included,all of cases had suffered from MDR/XDR Ab intracranial infection after neurosurgery.(Post-craniotomy,ventriculo-peritoneal shunt,endoscopic surgery,craniocerebral puncture,etc.)Patients were diⅵded into Ⅳ group(nine patients,Ⅳ therapy alone)and Ⅳ+ⅣT group(nine patients,Ⅳ plus ⅣT tigecycline).ResultsCerebrospinal fluid sterilization was recorded in 12 of 18 patients(66.6%).The average time for CSF sterilization was 21 days(range 8-48),with the CSF sterilization rate of Group Ⅳ being 33.3% and the sterilization rate of the Ⅳ + ⅣT group being 100%(P<0.05).Seven patients died of Ab-intracranial infection associated with Ab-intracranial infection.No obⅵous side effects caused by intraventricular administration of tigecycline was observed.ConclusionⅣ therapy combined with ⅣT therapy tigecycline was more effective than Ⅳ therapy alone,significantly improved patient prognosis,and no obⅵous side effects of tigecycline on patients were observed during treatment.Through analysis,this study believes that Ⅳ therapy with ⅣT therapy tigecycline for the treatment of MDR/XDR Ab-intracranial infection after neurosurgery has a significant effect.