{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:58:37Z","timestamp":1753887517901,"version":"3.41.2"},"reference-count":16,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,1,1]]},"abstract":"<jats:p>Shunt infections are seen in 3% to 20% of patients who have cerebrospinal fluid (CSF) shunts. Although the staphylococcal species are the most common cause of shunt-related infections, Gram-negative bacteria are increasingly reported with higher mortality rates. Tigecycline, a glycylcycline, is not approved for children. But in the era of nosocomial infections due to multidrug-resistant pathogens, it can be the life-saving option. We report an infant with ventriculoperitoneal shunt\u2013related meningitis treated with a tigecycline combination regimen. A 5-month-old boy who had a ventriculoperitoneal shunt was admitted with meningitis. Extended spectrum \u03b2-lactamase\u2013producing Klebsiella pneumoniae grew in the CSF. At the end of the fourth week of intravenous meropenem plus gentamicin therapy, carbapenem-resistant K pneumoniae grew in the CSF (mean inhibitory concentration value for meropenem &amp;gt;4 \u03bcg\/mL, by E-test). The infected shunt was removed, and an external ventricular drainage catheter was inserted. With permission, intravenous tigecycline (1.2 mg\/kg per dose twice a day) and intrathecal amikacin were added to the meropenem. Intrathecal amikacin could be given for only 7 days. On the sixth day of tigecycline treatment, the CSF was sterilized. Antibiotic therapy was given and consisted of a total of 60 days of meropenem and 20 days of tigecycline therapy. Because no available efficacy and safety data from randomized-controlled studies exist, tigecycline must be used only as salvage therapy, in combination with other drugs, for critically ill children who have no alternative treatment options.<\/jats:p>","DOI":"10.1542\/peds.2016-0963","type":"journal-article","created":{"date-parts":[[2016,12,14]],"date-time":"2016-12-14T10:10:34Z","timestamp":1481710234000},"source":"Crossref","is-referenced-by-count":18,"title":["Tigecycline Therapy in an Infant for Ventriculoperitoneal Shunt Meningitis"],"prefix":"10.1542","volume":"139","author":[{"given":"Melike","family":"Emiroglu","sequence":"first","affiliation":[{"name":"Departments of Pediatric Infectious Diseases and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gulsum","family":"Alkan","sequence":"additional","affiliation":[{"name":"Departments of Pediatric Infectious Diseases and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hatice","family":"Turk Dagi","sequence":"additional","affiliation":[{"name":"Microbiology, Selcuk University Faculty of Medicine, Konya, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2017,1,1]]},"reference":[{"issue":"12","key":"2021120904212462300_B1","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.3346\/jkms.2012.27.12.1563","article-title":"Incidence and risk factors of ventriculoperitoneal shunt infections in children: a study of 333 consecutive shunts in 6 years.","volume":"27","author":"Lee","year":"2012","journal-title":"J Korean Med Sci"},{"issue":"4","key":"2021120904212462300_B2","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1542\/peds.59.4.614","article-title":"Gram-negative cerebrospinal fluid shunt-associated infections.","volume":"59","author":"Sells","year":"1977","journal-title":"Pediatrics"},{"issue":"1","key":"2021120904212462300_B3","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1093\/qjmed\/93.1.45","article-title":"Klebsiella pneumoniae meningitis: timing of antimicrobial therapy and prognosis.","volume":"93","author":"Fang","year":"2000","journal-title":"QJM"},{"issue":"10","key":"2021120904212462300_B4","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1517\/14656566.2014.914172","article-title":"Multidrug-resistant and extensively drug-resistant Gram-negative pathogens: current and emerging therapeutic approaches.","volume":"15","author":"Karaiskos","year":"2014","journal-title":"Expert Opin Pharmacother"},{"volume-title":"Performance Standards for Antimicrobial Susceptibility Testing. Twenty-third informational supplement. CLSI document M100-S23","year":"2013","author":"Clinical and Laboratory Standards Institute","key":"2021120904212462300_B5"},{"issue":"45","key":"2021120904212462300_B6","doi-asserted-by":"crossref","first-page":"30062","DOI":"10.2807\/1560-7917.ES.2015.20.45.30062","article-title":"Carbapenemase-producing Enterobacteriaceae in Europe: assessment by national experts from 38 countries, May 2015.","volume":"20","author":"Albiger","year":"2015","journal-title":"Euro Surveill"},{"author":"Pfizer, USA","key":"2021120904212462300_B7"},{"journal-title":"J Pediatric Infect Dis Soc","article-title":"Use of tigecycline in pediatric patients with infections predominantly due to extensively drug-resistant gram-negative bacteria","author":"Iosifidis","key":"2021120904212462300_B8"},{"issue":"4","key":"2021120904212462300_B9","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1097\/INF.0b013e3181c806d8","article-title":"Multidrug-resistant Enterococcus faecium meningitis in a toddler: characterization of the organism and successful treatment with intraventricular daptomycin and intravenous tigecycline.","volume":"29","author":"Jaspan","year":"2010","journal-title":"Pediatr Infect Dis J"},{"key":"2021120904212462300_B10","doi-asserted-by":"crossref","first-page":"bcr0220113807","DOI":"10.1136\/bcr.02.2011.3807","article-title":"Multidrug-resistant Acinetobacter baumannii infection in children.","volume":"2011","author":"De Luca","year":"2011","journal-title":"BMJ Case Rep"},{"issue":"6","key":"2021120904212462300_B11","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1093\/jac\/dkl403","article-title":"Serum, tissue and body fluid concentrations of tigecycline after a single 100 mg dose.","volume":"58","author":"Rodvold","year":"2006","journal-title":"J Antimicrob Chemother"},{"issue":"3","key":"2021120904212462300_B12","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1345\/aph.1M480","article-title":"Cerebral spinal fluid penetration of tigecycline in a patient with Acinetobacter baumannii cerebritis.","volume":"44","author":"Ray","year":"2010","journal-title":"Ann Pharmacother"},{"issue":"1","key":"2021120904212462300_B13","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1097\/IPC.0b013e318181fa38","article-title":"Tigecyline for the treatment of multidrug-resistant Klebsiella pneumoniae meningitis.","volume":"17","author":"Dandache","year":"2009","journal-title":"Infect Dis Clin Pract"},{"key":"2021120904212462300_B14","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/1476-0711-12-24","article-title":"Antimicrobial susceptibility among gram-negative isolates collected in the USA between 2005 and 2011 as part of the Tigecycline Evaluation and Surveillance Trial (T.E.S.T.).","volume":"12","author":"Denys","year":"2013","journal-title":"Ann Clin Microbiol Antimicrob"},{"issue":"4","key":"2021120904212462300_B15","doi-asserted-by":"crossref","first-page":"2322","DOI":"10.1128\/AAC.02166-13","article-title":"Carbapenemase-producing Klebsiella pneumoniae bloodstream infections: lowering mortality by antibiotic combination schemes and the role of carbapenems.","volume":"58","author":"Daikos","year":"2014","journal-title":"Antimicrob Agents Chemother"},{"issue":"11","key":"2021120904212462300_B16","doi-asserted-by":"crossref","first-page":"e3126","DOI":"10.1097\/MD.0000000000003126","article-title":"Tigecycline treatment for carbapenem-resistant Enterobacteriaceae infections: a systematic review and meta-analysis.","volume":"95","author":"Ni","year":"2016","journal-title":"Medicine (Baltimore)"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2016-0963\/1097333\/peds_20160963.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2016-0963\/1097333\/peds_20160963.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,17]],"date-time":"2022-07-17T03:34:21Z","timestamp":1658028861000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/139\/1\/e20160963\/51719\/Tigecycline-Therapy-in-an-Infant-for"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1,1]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,1,1]]},"published-print":{"date-parts":[[2017,1,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2016-0963","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"type":"print","value":"0031-4005"},{"type":"electronic","value":"1098-4275"}],"subject":[],"published":{"date-parts":[[2017,1,1]]},"article-number":"e20160963"}}