Central nervous system infections in the intensive care unit

Vengamma, B; Rajguru, M.; Prasad, B. C. M.; Chandra, VV Ramesh

doi:10.15380/2277-5706.jcsr.13.044

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…There are only few studies available from India with regard to the causative organisms and drug sensitivities of PCNSIs. [2,3,28] The present study demonstrated that the distribution of pathogens from our region was similar to the trend observed globally, thus helping the clinicians to choose the appropriate empirical antibiotic treatment for PCNSIs. The limitations of the study were that data with regard to clinical variables were not studied, the isolates included in the study may not be a representative for the whole of India, and the isolates were not characterized to molecular level to depict the resistance characteristics.…”

Section: Discussionsupporting

confidence: 77%

Prevalence and antibiotic resistance profile of cerebrospinal fluid pathogens from neurosurgical patients from level 1 trauma center in India

et al. 2019

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Introduction: The purpose of this study was to investigate the prevalence of Postoperative central nervous system infections (PCNSIs) and antibiotic resistance profiles of causative organisms in trauma patients following neuroinvasive procedures. Materials and Methods: This was a retrospective study conducted over a period of 4 years (2013–2017). All in-patients admitted under a neurotrauma unit meeting the inclusion criteria of PCNSIs were included in the study. Surgical site infections (SSIs) were defined according to the Centers for Disease Control and Prevention 2018 (CDC) criteria. We retrospectively examined the demographic characteristics, type of neurosurgery performed, laboratory data, causative organisms, and antimicrobial susceptibility testing results of patients who had positive cerebrospinal fluid cultures following craniotomy between January 2013 and December 2017. Results: Of total 2500 patients operated during the study, 961 patients were screened for PCNSIs. The estimated prevalence (95% confidence interval) of PCNSIs which is a type of organ/space SSI was 7.2% (6.3–8.3). Males were predominantly affected (85.0%). The mean age (standard deviation) of patients was 31.9 (16.5) years. Of all the cultures sent for microbiological examination, 18.6% were positive. The proportion of Gram-negative bacteria causing PCNSIs was 91.6%. Multidrug-resistant (MDR) Acinetobacter baumannii (41%) was the most common organism isolated. Among Gram-positive bacteria, the most common organism was Staphylococcus aureus (5.5%). All the Gram-positive isolates were susceptible to vancomycin, teicoplanin, and linezolid. Conclusion: There is a high burden of PCNSI caused by MDR Acinetobacter baumannii can pose a major clinical challenge with only few antimicrobials left in the pipeline.

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Section: Discussionsupporting

confidence: 77%

Prevalence and antibiotic resistance profile of cerebrospinal fluid pathogens from neurosurgical patients from level 1 trauma center in India

et al. 2019

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“…The best test to confirm CNS infection is the detection of pathogens in CSF culture [3,15]. This study included 68 (68.7%) positive CSF samples which had history of neurosurgical procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Bacterial infections have been known as the most common cause of the CNS infections, meanwhile fungi and mycobacteria are also frequently reported [3]. The pattern of pathogens recovered from CSF culture varies from Gram-positive cocci to multidrug-resistant Gram-negative bacteria depending on geographic region, age, co-morbidities, type of neurosurgical procedures, and site of infection [1,4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Neurosurgical site of infections after a neurosurgical procedure remains an important issue with overall infection rate of 0.4 % to 7.7% [3,6,7]. Studies have shown the main organisms that cause postneurosurgical infection were non-lactose fermenting gram-negative bacteria (GNB) followed by A. baumanii, K.pneumoniae, methicillin-resistant Staphylococcus aureus (MRSA), and Candida species [5,7,8].…”

Section: Introductionmentioning

confidence: 99%

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The changing microbiological and antimicrobial susceptibility profile of cerebrospinal fluid organism isolates in a teaching hospital, Tangerang, Indonesia

Cucunawangsih

Wiwing²,

Lugito³

et al. 2015

int. arab. j antimicrob. agents

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Background: Central nervous system (CNS) infections have become serious problems that contribute to morbidity and mortality in developing countries. In the recent years, antimicrobial resistance has arisen parallel with the changing trend of infectious pathogens, which resulted in the unavailability of an ideal antimicrobial agent. This study was designed to evaluate the central nervous system pathogens and their susceptibility profile using routine microbiological data.

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A retrospective analysis of 20,178 adult neurological infection admissions to United Kingdom critical care units from 2001 to 2020

Donovan,

Glover,

Gregson

et al. 2024

BMC Infect Dis

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Background Neurological infection is an important cause of critical illness, yet little is known on the epidemiology of neurological infections requiring critical care. Methods We analysed data on all adults with proven or probable neurological infection admitted to UK (NHS) critical care units between 2001 and 2020 reported to the Intensive Care National Audit and Research Centre. Diagnoses, physiological variables, organ support and clinical outcomes were analysed over the whole period, and for consecutive 5-year intervals within it. Predictors of in-hospital mortality were identified using a backward stepwise regression model. Results We identified 20,178 critical care admissions for neurological infection. Encephalitis was the most frequent presentation to critical care, comprising 6725 (33.3%) of 20,178 cases. Meningitis– bacterial, viral or unspecified cases - accounted for 10,056 (49.8%) of cases. In-hospital mortality was high, at 3945/19,765 (20.0%) overall. Over the four consecutive 5-year periods, there were trends towards higher Glasgow Coma Scale scores on admission, longer critical care admissions (from median 4 [IQR 2–8] to 5 days [IQR 2–10]), and reduced in-hospital mortality (from 24.9 to 18.1%). We identified 12 independent predictors of in-hospital death which when used together showed good discrimination between patients who die and those who survive (AUC = 0.79). Conclusions Admissions with neurological infection to UK critical care services are increasing and the mortality, although improving, remains high. To further improve outcomes from severe neurological infection, novel approaches to the evaluation of risk stratification, monitoring and management strategies are required.

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Central nervous system infections in the intensive care unit

Abstract: Burden of the problem Indian scenario Sparse published data are available on the spectrum of neurological infections requiring

Cited by 4 publications

References 7 publications

Prevalence and antibiotic resistance profile of cerebrospinal fluid pathogens from neurosurgical patients from level 1 trauma center in India

Prevalence and antibiotic resistance profile of cerebrospinal fluid pathogens from neurosurgical patients from level 1 trauma center in India

The changing microbiological and antimicrobial susceptibility profile of cerebrospinal fluid organism isolates in a teaching hospital, Tangerang, Indonesia

A retrospective analysis of 20,178 adult neurological infection admissions to United Kingdom critical care units from 2001 to 2020

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