Intraventricular Colistin in postoperative infection by resistant Pseudomonas aeruginosa: Report of a pediatric case

Abstract

Introduction: The emergence of multi-resistant Gram-negative bacteria and the emergence of post-operative infections has represented a challenge in antimicrobial management. The structural characteristics of these bacteria, the formation of biofilms in internal devices and the presence of infections in organs of difficult antimicrobial access such as the central nervous system, has forced to consider the use of antibiotics such as Colistine through little-used administration routes.

Clinical case: We present the clinical case of a 2-year-old patient with post-surgical meningo-ventriculitis caused by multiresistant Pseudomonas aeruginosa managed with combined treatment of intraventricular and intravenous Colistin, resulting in therapeutic success for the patient. No adverse reaction to local or systemic medication was reported. No infectious relapses were reported after discharge.

Conclusions: The key aspects in the management of this type of infection have been considered: elimination of the infected peritoneal ventricle derivation, optimal antimicrobial coverage and choice of the most effective route of administration.