BACKGROUNDInfectious complications of Ommaya reservoirs occur in 3–15% of patients and can lead to removal of the device and other complications. Removal of the device is suboptimal as intrathecal chemotherapy is then delayed or discontinued. Gram positive skin flora, staphylococci and Propionibacterium acnes, are the most common colonizers of the reservoir. Understanding how to treat these bacteria can prevent poor outcomes. Both staphylococci and P. acnes are biofilm-forming bacteria. In implants colonized with P. acnes, a modeling study showed single agent rifampin to have a 36% cure rate. Despite good biofilm penetration, Rifampin’s bactericidal activity is not as effective as when combined with other agents. When combined with daptomycin, the cure rate increased to 63%.
展开▼
