Outcome following postneurosurgical Acinetobacter meningitis: an institutional experience of 72 cases

Sharma, Ravi; Goda, Revanth; Borkar, Sachin A; Katiyar, Varidh; Agarwal, Samagra; Kumar, Amandeep; Mohapatra, Sarita; Kapil, Arti; Suri, Ashish; Kale, Shashank S.

doi:10.3171/2019.5.focus19278

“…83.3% (5/6) of the isolates of Acinetobacter baumannii were XDR bacteria in our study, while an Indian study reported that 20.8% of Acinetobacter isolates were XDR strains [34]. An obvious difference was the sensitivity to cefoperazone-sulbactam, approximately 74% of the Acinetobacter isolates were found to be sensitive to cefoperazone-sulbactam in India [34], yet the 6 Acinetobacter baumannii isolates were all resistant in our study. The data from two Chinese hospitals indicated that Acinetobacter baumannii had low sensitivity to cefoperazone-sulbactam (5.3% and 16.3%) [21,26].…”

Section: Risk Factors For Mdr Bacterial Infectionscontrasting

confidence: 52%

Epidemiology of patients with central nervous system infections, mainly neurosurgical patients: a retrospective study from 2012 to 2019 in a teaching hospital in China

Zheng

¹

,

Song

²

,

Kang

³

et al. 2021

View full text Add to dashboard Cite

Background Central nervous system (CNS) infections are relatively rare but are associated with high mortality worldwide. Empirical antimicrobial therapy is crucial for the survival of patients with CNS infections, and should be based on the knowledge of the pathogen distribution and antibiotic sensitivities. The aim of this study was to investigate the features of pathogens in patients with CNS infections in North China and evaluate the risk factors for mortality and multi-drug-resistant (MDR) bacterial infections. Methods A retrospective study was conducted with patients with positive cerebrospinal fluid (CSF) cultures in a teaching hospital from January 2012 to December 2019. The following data were collected: demographic characteristics, laboratory data, causative organisms and antimicrobial sensitivity results. Data were analyzed with SPSS 16.0. Univariate analysis and binary logistic regression analyses were performed to identify the risk factors for mortality and MDR bacterial infections. Results A total of 72 patients were diagnosed with CNS infections, and 86 isolates were identified. The proportions of Gram-positive bacteria, Gram-negative bacteria and fungi were 59.3, 30.2 and 10.5%, respectively. The predominant Gram-positive bacteria was Coagulase-negative Staphylococci. Acinetobacter baumannii, Escherichia coli and Klebsiella spp. were the predominant Gram-negative bacteria. Compared to 2012–2015 years, the proportion of Gram-negative bacteria increased markedly during 2016–2019 years. Coagulase-negative Staphylococci, Streptococcus pneumoniae and Enterococcus faecium had 100% sensitivity to vancomycin, teicoplanin and linezolid. Acinetobacter baumannii and Klebsiella pneumoniae were 100% sensitive to tigecycline. Escherichia coli had 100% sensitivity to amikacin, meropenem and imipenem. The overall mortality rate in the 72 patients was 30.6%. In multivariate analysis, age > 50 years, pulmonary infections and CSF glucose level < the normal value were associated with poor outcomes. CSF adenosine deaminase level > the normal value and the presence of external ventricular drainage/lumbar cistern drainage were associated with MDR bacterial infections. Conclusions The mortality rate due to CNS infections reached 30.6% in our study. The proportion of Gram-negative bacteria has increased markedly in recent years. We should give particular attention to patients with risk factors for mortality and MDR bacterial infections mentioned above.

show abstract

“…Therefore, it is important to determine the risk factors affecting the outcomes of patients with bacterial CNS infections, particularly in developing countries. Previous studies predicted survival following CNS infections and suggested that age > 40 years, presence of external ventricular drainage, low CSF glucose levels, high CSF protein levels, CSF leukocyte count > 200 cells/mm 3 , ICU admission, and the presence of comorbidities were risk factors for mortality [31,38,39]. In our analysis, age > 50, comorbidity (pulmonary infection) and CSF glucose < normal value were independent risk factors for mortality.…”

Section: Discussionsupporting

confidence: 52%

Epidemiology, pathogens distribution, antibiotic susceptibility and the risk factors for mortality of patients with central nervous system infections: a retrospective study from 2012 to 2019 in a teaching hospital in China

Zhang

¹

,

Song

²

,

Kang

³

et al. 2021

Preprint

0

View full text Add to dashboard Cite

Background: Central nervous system (CNS) infections are relatively rare but associated with high mortality worldwide. Empirical antimicrobial therapy is crucial for the prognosis of patients with CNS infections, which should be based on the knowledge of pathogens distribution and antibiotic sensitivities. China is a vast country, and the pathogens distribution varies nationwide. The aim of this study is to investigate the features of pathogens in patients with CNS infections in north China and we tried to evaluate the risk factors for mortality.Methods: We retrospectively analyzed the patients with positive cerebrospinal fluid (CSF) culture in a teaching hospital between January 2012 and December 2019. The following information were collected: demographic characteristics, laboratory data, causative organisms and antimicrobial susceptibility results. Univariate analysis and binary logistic regression analysis were performed to identify the risk factors for mortality.Results: In this eight-year retrospective study, a total of 72 patients were diagnosed with CNS infections and 86 isolates were identified. Among all the microorganisms detected, Gram-positive strains consisted of 59.3%, Gram-negative bacteria of 30.2% and fungi of 10.5%. The predominant Gram-positive isolate was coagulase-negative staphylococci. Acinetobacter baumannii, Escherichia coli and Klebsiella were the common Gram-negative strains. Compared to 2012-2015 years, the proportion of Gram-negative bacteria increased markedly during 2016-2019 years. Vancomycin, teicoplanin and linezolid were still 100% sensitive to Gram-positive bacteria. For the multidrug-resistant Gram-negative bacteria, only tigecycline was the 100% sensitive antibiotics. The mortality of the 72 patients was 30.6%. In the multivariate analysis, age >50 years, combined pulmonary infection and CSF glucose < normal value were associated with poor prognosis. Conclusions: CNS infections cause high mortality worldwide. Although Gram-positive bacteria are still the primary pathogen of CNS infections, Gram-negative bacteria had increased in recent years and should be considered in the choice of empirical antibiotic treatment. Special attention should be given to older patients and those combined pulmonary infection and with low CSF glucose level.

show abstract

“…Previous studies predicted survival following CNS infections and suggested that age > 40 years, presence of external ventricular drainage, low CSF glucose levels, high CSF protein levels, CSF leukocyte count > 200 cells/mm 3 , ICU admission, and the presence of comorbidities were risk factors for mortality [31,38,39]. In our analysis, age > 50, comorbidity (pulmonary infection) and CSF glucose < normal value were independent risk factors for mortality.…”

Section: Discussionsupporting

confidence: 52%

“…For the Gram-negative isolates, XDR strains accounted for 20.8% of the Acinetobacter in an Indian study [31], yet, 83.3% (5/6) of the Acinetobacter baumannii strains were XDR bacteria as we showed. An obvious distinction was the sensibility to cefoperazone-sulbactum, approximately 74% of the Acinetobacter isolates were found to be sensitive to it in Indian [31]. However, Acinetobacter baumannii strains were all resistant to it in our study.…”

Section: Discussionsupporting

confidence: 51%

Epidemiology, Pathogens Distribution, Antibiotic Susceptibility and the Risk Factors for Mortality of Patients With Central Nervous System Infections: a Retrospective Study From 2012 to 2019 in a Teaching Hospital in China

Zhang

¹

,

Song

²

,

Kang

³

et al. 2021

Preprint

0

View full text Add to dashboard Cite

Background: Central nervous system (CNS) infections are relatively rare but associated with high mortality worldwide. Empirical antimicrobial therapy is crucial for the prognosis of patients with CNS infections, which should be based on the knowledge of pathogens distribution and antibiotic sensitivities. China is a vast country, and the pathogens distribution varies nationwide. The aim of this study is to investigate the features of pathogens in patients with CNS infections in north China and we tried to evaluate the risk factors for mortality.Methods: We retrospectively analyzed the patients with positive cerebrospinal fluid (CSF) culture in a teaching hospital between January 2012 and December 2019. The following information were collected: demographic characteristics, laboratory data, causative organisms and antimicrobial susceptibility results. Univariate analysis and binary logistic regression analysis were performed to identify the risk factors for mortality.Results: In this eight-year retrospective study, a total of 72 patients were diagnosed with CNS infections and 86 isolates were identified. Among all the microorganisms detected, Gram-positive strains consisted of 59.3%, Gram-negative bacteria of 30.2% and fungi of 10.5%. The predominant Gram-positive isolate was coagulase-negative staphylococci. Acinetobacter baumannii, Escherichia coli and Klebsiella were the common Gram-negative strains. Compared to 2012-2015 years, the proportion of Gram-negative bacteria increased markedly during 2016-2019 years. Vancomycin, teicoplanin and linezolid were still 100% sensitive to Gram-positive bacteria. For the multidrug-resistant Gram-negative bacteria, only tigecycline was the 100% sensitive antibiotics. The mortality of the 72 patients was 30.6%. In the multivariate analysis, age >50 years, combined pulmonary infection and CSF glucose < normal value were associated with poor prognosis. Conclusions: CNS infections cause high mortality worldwide. Although Gram-positive bacteria are still the primary pathogen of CNS infections, Gram-negative bacteria had increased in recent years and should be considered in the choice of empirical antibiotic treatment. Special attention should be given to older patients and those combined pulmonary infection and with low CSF glucose level.

show abstract

Outcome following postneurosurgical Acinetobacter meningitis: an institutional experience of 72 cases

Cited by 24 publications

References 14 publications

Epidemiology of patients with central nervous system infections, mainly neurosurgical patients: a retrospective study from 2012 to 2019 in a teaching hospital in China

Epidemiology of patients with central nervous system infections, mainly neurosurgical patients: a retrospective study from 2012 to 2019 in a teaching hospital in China

Epidemiology, pathogens distribution, antibiotic susceptibility and the risk factors for mortality of patients with central nervous system infections: a retrospective study from 2012 to 2019 in a teaching hospital in China

Epidemiology, Pathogens Distribution, Antibiotic Susceptibility and the Risk Factors for Mortality of Patients With Central Nervous System Infections: a Retrospective Study From 2012 to 2019 in a Teaching Hospital in China

Contact Info

Product

Resources

About