Intracranial malignant lesions correlate with the requirement for a long treatment course in postoperative central nervous system infection

Abstract

AimOur aim was to study the clinical features of postoperative meningitis after neurosurgery and identify the factors affecting the duration of treatment.MethodsThis retrospective study assessed 283 patients with postoperative bacterial meningitis in the Neurosurgery Department of Beijing Tiantan Hospital, Beijing, People’s Republic of China, between January and December 2012. Patients’ clinical data were reviewed, and multivariate logistic regression analysis was used to identify the factors associated with a prolonged treatment course.ResultsThe mortality rate was 0.4% in these patients, of whom 12.4% were found with pathogens in the cerebrospinal fluid. Among the three most common pathogens detected were methicillin-resistant Staphylococcus aureus, Acinetobacter baumannii, and Pseudomonas aeruginosa. The mean treatment course was 13.5±2.1 days. Interestingly, the treatment duration for postoperative meningitis was significantly longer in patients with intracranial malignant tumors than in those with benign lesions. Single-factor analysis showed that male sex (P=0.042) and malignant (rather than benign) lesions (P<0.001) were significantly associated with prolonged treatment duration. Multivariate analysis further confirmed that malignant intracranial lesions represented an independent risk factor for prolonged treatment duration (odds ratio: 2.5962; 95% confidence interval: 1.1092–6.6134).ConclusionThe nature of the intracranial lesion is an independent risk factor for the duration of treatment in postoperative meningitis after neurosurgery.

The Association of Adherence to Antimicrobial Prophylactic Recommendations for Clean Neurosurgeries with Post-operative Surgical Site Infection

“…Intracranial mass as a risk factor for SSI is also consistent with other studies which show that meningioma, brain metastasis surgery and intracranial malignant lesions are risk factors for SSI. 5,14 The larger proportion of SSI cases in surgeries done for >4 hours support that duration of surgery is a significant risk factor. In a study by Korinek, et al which looked at risk factors for neurosurgical site infections after craniotomy, duration of surgery was confirmed to be an independent risk factor which may indicate difficulties in surgery, surgeon expertise and occurrence of intra-operative complications.…”

Characteristics of Post-Neurosurgical Nosocomial Bacterial Meningitis in Adults: A retrospective Cross-Sectional Study

“…CSF should be acquired as soon as possible for analysis. (8)(9)(10)(11)(12)(13)(14)(15)(16) The most commonly found infectious pathogens are commensal organisms of the external auditory canal and nasopharynx in patients diagnosed with post-neurosurgical meningitis however the likelihood of nosocomial infection is recommended not to be overlooked. Aspiration of stomach contents is prevalent in individuals who have had a head injury, and it is typically worsened by bacterial superinfection.…”

Bacterial Meningitis among Intracranial Surgery Patients at a University Hospital in Northern India

“…2 , 3 Meningitis remains the main reason for poor prognosis in postoperative intracranial surgeries in patients after neurosurgery. 4 The patients included in this study have undergone craniotomies and other endoscopic intracranial surgeries due to both benign and malignant lesions, and isolation of postoperative meningeal infections further delays the improvement in neurological functions of the patient and may progress to cause disability or death. 5…”