2145. Etiology, Incidence and Risk Factors for Meningitis after Craniotomy

Abstract

BackgroundMeningitis after craniotomy can be devastating. The objective of our study is to answer four questions: (a) what is the risk of meningitis after craniotomy? (b) What are the main microorganisms causing meningitis after craniotomy? (c) What is the impact of meningitis in the hospital length of stay and mortality? (d) What are risk factors for meningitis after craniotomy?MethodsSurveillance data based on NHSN/CDC protocols were collected between 2013 and 2017 from nine hospitals at Belo Horizonte, Brazil. Outcome: meningitis, hospital death and total length of hospital stay. Twenty-three independent variables were analyzed using Epi Info and applying statistical two-tailed test hypothesis with significance level of 5%.ResultsA sample of 4,549 patients submitted to craniotomy was analyzed: risk of meningitis = 1.9% (IC 95% = 1.6%; 2.4%). Mortality rate in patients without infection was 9% rising to 33% in infected patients (P < 0.01). Hospital length of stay in non-infected patients (days): mean = 18, median = 7, std. dev. = 36. Hospital stay in infected patients: mean = 56, median = 37, std. dev. = 63 (P < 0.001). The duration of procedure was the main risk factor for meningitis: 1.5% risk of meningitis in surgery less than or equal to 4 hours vs. 2.5% if the duration of procedure was more than 4 hours (relative risk = 1.7; P = 0.041). From 88 meningitis, in 68 (77%) the etiologic agent was identified: Klebsiella pneumoniae (20%), Staphylococcus aureus (16%), Acinetobacter baumannii (13%), Pseudomonas aeruginosa (9%), Staphylococcus sp. (8%), Acinetobacter sp. (7%), Staphylococcus epidermidis (5%), and other (20%).ConclusionThe study showed how much meningitis is devastating, rising the death risk and length of hospital stay.Disclosures All authors: No reported disclosures.