Mortality rate in patients with nosocomial Acinetobacter meningitis from a Brazilian hospital

ABSTRACT Background: The mortality rate due to Acinetobacter baumannii nosocomial meningitis (ANM) is high. Objective: The aim of this study was to evaluate the factors that have infl uence over the out-comes in ANM patients. Methods: A retrospective analysis of 22 cases of ANM was conducted in a hospital with high incidence of multidrug resistance. Results: The mean age of patients was 43 years (21 to 91) and 54.5% were male. All ANM cases occurred within 60 days of admission and the mean duration of illness was of 18.2 days. All cases were associated with previous neurosurgical procedures: elective surgery (27.2%), external shunt (54.4%) and emergency surgery due to trauma (18.1%). Imipenem resistance was observed in 40.9% of cases, but ampicillin/sulbactam resistance was lower (27.2%). The mortality rate of ANM patients was of 72.7%. The only risk factor associ-ated with mortality was inappropriate therapy within fi ve days after CSF collection. All patients who survived the meningitis episode had received appropriate therapy, in contrast to only 69.2% of those who did not survive (OR = 5.15; IC = 0.45-54.01).