| Summary: | Zheng He,1,* Chengcheng Wang,2,* Bin Liu,1 Maoyan Feng,2 Zhigang Wang1 1Department of Neurosurgery, Qilu Hospital of Shandong University (Qingdao), Qingdao, People’s Republic of China; 2Department of Clinical Pharmacy, Qilu Hospital of Shandong University (Qingdao), Qingdao, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhigang Wang Tel +86-532-96599Fax +86-532-66850532Email wzg1110@126.comBackground: Carbapenem-resistant Enterobacteriaceae (CRE) meningitis are associated with poor outcomes and high mortality. Here, we report the first successful treatment case of serious meningitis caused by extremely carbapenem-resistant Enterobacter cloacae (minimum inhibitory concentration (MIC) of imipenem ≥16mg/L) with high-dose prolonged infusion of meropenem and i.v. amikacin plus intraventricular (IVT) amikacin.Case presentation: A 17-year-old girl developed meningitis from an extremely carbapenem-resistant Enterobacter cloacae (MIC of imipenem ≥16mg/L) as a complication of the removal of a giant central neurocytoma located in bilateral and third ventricles. The patient received four surgeries (one tumor excision and three external ventricular drainages) and was treated with a 70 days course of antibiotics therapy during 100 days hospitalization. Finally, she was safely and successfully treated with the high-dose prolonged infusion of meropenem and i.v. amikacin plus IVT amikacin.Conclusion: This case report shows the possibility of the antibiotic regimen of high-dose prolonged infusion of meropenem and i.v. amikacin plus IVT amikacin in the successful treatment of CRE meningitis (MIC of imipenem ≥16mg/L) especially when other antibiotics are unavailable or restricted.Keywords: carbapenem-resistant enterobacteriaceae, meningitis, Enterobacter cloacae, meropenem, intraventricular amikacin
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