Significance of nucleic acid testing in diagnosis and treatment of post-neurosurgical meningitis caused by multidrug-resistant Acinetobacter baumannii: a case report. (December 2016)

• Record Type: Journal Article
• Authors: Trung, Ngo; Van Son, Trinh; Quyen, Dao; Anh, Dang; Sang, Vu; Lam, Nguyen; Manh, Nguyen; Duong, Vuong; Cuong, Bui; Tuyen, Quyen; Chinh, Nguyen; Hoan, Phan; Van Tong, Hoang; Meyer, Christian; Song, Le
• Is Part Of: Journal of medical case reports. Volume 10:Number 1(2016)
• Page Start: 1
• Page End: 4
• Publication Date: 2016-12
• Subjects: Neurosurgery -- Meningitis -- Acinetobacter baumannii -- Nucleic acid testing -- Bacterial culture -- Hospital infection; Medicine -- Research -- Periodicals; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1186/s13256-016-1104-3
• Languages: English
• ISSNs: 1752-1947

Abstract

Abstract Background Neurosurgery may pose the risk of patients' developing nosocomial meningitis caused by infection with hospital pathogens. Rapid detection of the causative pathogens is essential for selecting the appropriate antibiotic treatment. However, the classical culture-based detection of bacterial infection is time-consuming and often fails to establish the correct diagnosis. Molecular techniques offer improved diagnostic means to guide the proper antibiotic therapy. Case presentation A 32-year-old Vietnamese man underwent neurosurgery and subsequently developed meningitis. The classical bacterial culture method failed to detect any infectious agents, whereas polymerase chain reaction-based assays identifiedAcinetobacter baumannii as the causative pathogen. In addition, detection of the acquired extended-spectrum beta-lactamase geneVEB and carbapenem resistance genesNDM-1 andIMP suggested that the isolatedA. baumannii strain was multidrug resistant. Upon the establishment of the correct diagnosis, an adequate treatment regimen was chosen and he recovered completely. Conclusions This case report demonstrates the usefulness of the molecular approach as an important addendum and alternative to culture-based diagnosis in order to detect the pathogen causative for meningitis, including the indicators for resistance.