Hospital-acquired bacterial meningitis in neurosurgical patients

Buckwold, Frederick J.; Hand, Roger; Hansebout, Robert R.

doi:10.3171/jns.1977.46.4.0494

Cited by 91 publications

(31 citation statements)

References 32 publications

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“…Head trauma and neurosurgical procedures may cause insult to the defenses of the CNS, which may render the host susceptible to infection [10]. From this point of view, head trauma and/or postneurosurgical procedures including the insertion of a V-P shunt are important predisposing factors for mixed infection in adult bacterial meningitis, a finding which is consistent with other reports [11][12][13]. The causative pathogens found in these 12 cases were protean.…”

Section: Discussionsupporting

confidence: 87%

Mixed Infection in Adult Bacterial Meningitis

Chang

Huang

et al. 2000

Infection

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12 adult patients suffering from bacterial meningitis caused by mixed infection were identified at Kaohsiung Chang Gung Memorial Hospital over a period of 13 years (1986-1998), and they accounted for 6.5% (12/184) of our culture-proven adult bacterial meningitis. The 12 cases included seven males and five females, aged 17-74 years. Six of the 12 cases had community-acquired infections and the other six had nosocomially-acquired infections. Ten of the 12 cases had associated underlying diseases, with head trauma and/or neurosurgical procedure being the most frequent. Both gram-negative and gram-positive pathogens were identified in these 12 cases with gram-negative pathogens outnumbering the gram-positive ones. The implicated pathogens, starting with the most frequent, included Enterobacter species (Enterobacter cloacae, Enterobacter aerogenes), Klebsiella species (Klebsiella pneumoniae, Klebsiella oxytoca), Escherichia coli, Staphylococcus species (Staphylococcus aureus, Staphylococcus haemolyticus), Pseudomonas aeruginosa, Acinetobacter baumannii, Enterococcus, Serratia marcescens, Citrobacter diversus, Proteus mirabilis, Streptococcus viridans and Neisseria meningitidis. Six of the 12 cases were found to have multi-antibiotic-resistant strains, which included E. cloacae in one, A. baumannii in one, K. pneumoniae in one and S. aureus in three. The management of these 12 cases included appropriate antibiotics and neurosurgical procedures including shunt revision. Despite the complexity of implicated pathogens and the high incidence of emergence of resistant strains, the overall mortality rate (8.3%, 1/12) was not higher than that in adult bacterial meningitis. However, complete recuperation was difficult in adult patients with mixed bacterial meningitis.

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Section: Discussionsupporting

confidence: 87%

Mixed Infection in Adult Bacterial Meningitis

Chang

Huang

et al. 2000

Infection

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“…The occurrence of meningitis as a complication of spinal surgery, observed in one of our patients, although rare with an incidence of about 0.18% [31], has also been reported by others [3,21].…”

Section: Discussionsupporting

confidence: 87%

Treatment of fractures of the thoracolumbar spine by combined anteroposterior fixation using the Harms method

Defino

Rodriguez-Fuentes

1998

E Spine J

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“…BM necessitates prompt and early diagnosis because of its devastating consequences 8 . Use of bro a d s p e c t rum antibiotics is to be avoided because of high cost and risk to unaffected patients 2 , 3 .…”

Section: Discussionmentioning

confidence: 99%

CSF markers for diagnosis of bacterial meningitis in neurosurgical postoperative patients

Tavares

Machado

Matushita

et al. 2006

Arq. Neuro-Psiquiatr.

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-Objective: To evaluate the diagnostic usefulness of cerebral spinal fluid (CSF) cellularity, protein, neutrophils, glucose and lactate for detection of postoperative bacterial meningitis. Method: This p rospective study was conducted in 28 postoperative neuro s u rgical patients from 2002 to 2005 at University of São Paulo. The CSF markers were plotted in a receiver operating characteristic (ROC) curve to evaluate their accuracy. Results: Based on the area under ROC curve CSF glucose, cellularity, and lactate were cons i d e red good tests. Polymorphonuclear and protein did not achieve enough accuracy to be used clinicall y. Conclusion: The CSF glucose, lactate, and cellularity can be used for the diagnosis of bacterial meningitis. Moreover, it can be helpful to differentiate bacterial from aseptic meningitis.KEY WORDS: CSF, bacterial meningitis, neurosurgery, ROC analysis, postoperative infection. Baseadas na área sob a curva ROC, glicorraquia, celularidade e concentração de lactato foram considerados bons testes. A contagem de polimorf o n u c l e a res e a pro t e í n o rraquia não atingiram acurácia suficiente para serem utilizadas clinicamente. Conclusão: A glicorraquia, a concentração de lactato e a celularidade podem ser utilizadas clinicamente para o diagnóstico da meningite bacteriana. Esses marc a d o res também podem ser úteis na diferenciação entre meningite bacteriana e asséptica. PALAVRAS-CHAVE: meningite bacteriana, LCR, neurocirurgia, curva ROC, infecção pós-operatória.

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Hospital-acquired bacterial meningitis in neurosurgical patients

Cited by 91 publications

References 32 publications

Mixed Infection in Adult Bacterial Meningitis

Mixed Infection in Adult Bacterial Meningitis

Treatment of fractures of the thoracolumbar spine by combined anteroposterior fixation using the Harms method

CSF markers for diagnosis of bacterial meningitis in neurosurgical postoperative patients

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