Multidrug-resistant Gram-negative post-neurosurgical meningitis and the role of intraventricular colistin: a case series.

The aim of this study was to report the clinical experience of intraventricular colistin for the treatment of multi-resistant Gram-negative post-surgical meningitis in a tertiary hospital. Post-neurosurgical meningitis (PNM) is one of the life-threatening complications of neurosurgical procedures, and is frequently sustained by Acinetobacter baumannii and Klebsiella pneumoniae. Here we describe our experience of five cases of PNM caused by gram-negative multi-drug resistant (MDR) bacteria, treated with intraventricular (IVT) colistin, admitted to the Neurosurgery Unit of A.

[Comparing two different techniques to assess the appropriateness of admissions provided in the emergency room of a pediatric hospital].

Two different techniques aimed to assess the appropriateness of hospital utilisation were used to study the same sample of clinical records of admissions provided during 2001 by the emergency room of a pediatric sicilian hospital. The first technique estimated the '"high risk of inappropriateness" DRGs prevalence, according to the Decreto del Presidente del Consiglio dei Ministri of 29 Novembre 2001, and the second was the pediatric version of the Appropriateness Evaluation Protocol (AEP), based on clinical characteristics of patients and complexity of assistance provided. The comparison of results did not show any agreement between the two techniques (kappa= 0,031, C.