Intrathecal or Intraventricular Tigecycline Therapy for Central Nervous System Infection Associated with Carbapenem-Resistant Klebsiella pneumoniae

• Published in: Infection and drug resistance Vol. 15; pp. 7219 - 7226
• Main Authors: Du, Ning, Mao, En-Qiang, Yang, Zhi-Tao, Qu, Hong-Ping, Qian, Xian, Shi, Ying, Bian, Xiao-Lan, He, Juan, Chen, Er-Zhen
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 31.12.2022; Dove; Dove Medical Press
• Subjects: Analysis; Bacterial pneumonia; carbapenem-resistant klebsiella pneumoniae; Case Series; Central nervous system; central nervous system infection; cns; crkp; Health aspects; Imipenem; Pneumonia; tigecycline; treatment; China; treatment; CNS; CRKP; central nervous system infection; carbapenem-resistant Klebsiella pneumoniae; tigecycline
• ISSN: 1178-6973; 1178-6973
• DOI: 10.2147/IDR.S387346

Infection with carbapenem-resistant (CRKP) is a great challenge. Central nervous system (CNS) infection caused by CRKP is rarely reported, and effective treatment is limited. Thus, this study aimed to assess intrathecal (IT) or intraventricular (IVT) injection of tigecycline for clearing infection with CRKP in CNS. Two patients who had intracranial infection with CRKP after craniotomy were treated in our institution and analyzed retrospectively, summarizing their therapeutic schedules. They all had a fever with the positive results of cerebrospinal fluid (CSF) test, and CSF culture showed positive for CPKP, which was sensitive only to tigecycline. In addition, the MIC of polymyxin B was not tested due to the limited laboratory conditions. After IT or IVT injection of tigecycline treatment, the temperature of the patients became normal in 3 days, with normal levels of white blood cells, protein, glucose and chlorine concentrations in the CSF. Crucially, twice CSF cultures also became negative with no clinical symptoms of intracranial infection after IT or IVT injection of tigecycline treatment. Moreover, there were no adverse drug reactions observed. IT or IVT injection of tigecycline may be a bright choice to control intracranial infection with CRKP.