The incidence of postoperative meningitis in neurosurgery: An institutional experience

Srinivas, Dwarakanath; Kumari, HB Veena; Somanna, Sampath; Indiradevi, B; Anandappa, Chandramouli B.

doi:10.4103/0028-3886.79136

Cited by 50 publications

(48 citation statements)

References 15 publications

(26 reference statements)

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“…This study included 68 (68.7%) positive CSF samples which had history of neurosurgical procedures. This result is much higher than several studies noted that the incidence of intracranial postneurosurgical infection have been ranged between 0.4% to 7.7% [4,5,6,7]. The profile of CSF isolates in this study showed that certain bacteria species were the predominant cause of CNS infection and was similar to other studies [1,2,8,10] .…”

Section: Discussioncontrasting

confidence: 38%

“…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%

“…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%

See 2 more Smart Citations

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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Section: Discussioncontrasting

confidence: 38%

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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“…This has not been described before in studies regarding PCM and in most studies regarding postoperative wound infections in general neurosurgical patients. 4,5,[12][13][14][15]23,26,28,33 The effect of steroids on patients undergoing neurosurgical procedures has been variably reported. 21 In certain studies, the steroid effect has not been specifically investigated.…”

Section: 23mentioning

confidence: 99%

Infections in patients undergoing craniotomy: risk factors associated with post-craniotomy meningitis

Kourbeti¹,

Vakis²,

Ziakas

et al. 2015

JNS

129

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OBJECT The authors performed a prospective study to define the prevalence and microbiological characteristics of infections in patients undergoing craniotomy and to clarify the risk factors for post-craniotomy meningitis. METHODS Patients older than 18 years who underwent nonstereotactic craniotomies between January 2006 and December 2008 were included. Demographic, clinical, laboratory, and microbiological data were systemically recorded. Patient characteristics, craniotomy type, and pre- and postoperative variables were evaluated as risk factors for meningitis RESULTS Three hundred thirty-four procedures were analyzed (65.6% involving male patients). Traumatic brain injury was the most common reason for craniotomy. Almost 40% of the patients developed at least 1 infection. Ventilatorassociated pneumonia (VAP) was the most common infection recorded (22.5%) and Acinetobacter spp. were isolated in 44% of the cases. Meningitis was encountered in 16 procedures (4.8%), and CSF cultures were positive for microbial growth in 100% of these cases. Gram-negative pathogens (Acinetobacter spp., Klebsiella spp., Pseudomonas aeruginosa, Enterobacter cloaceae, Proteus mirabilis) represented 88% of the pathogens. Acinetobacter and Klebsiella spp. demonstrated a high percentage of resistance in several antibiotic classes. In multivariate analysis, the risk for meningitis was independently associated with perioperative steroid use (OR 11.55, p = 0.005), CSF leak (OR 48.03, p < 0.001), and ventricular drainage (OR 70.52, p < 0.001). CONCLUSIONS Device-related postoperative communication between the CSF and the environment, CSF leak, and perioperative steroid use were defined as risk factors for meningitis in this study. Ventilator-associated pneumonia was the most common infection overall. The offending pathogens presented a high level of resistance to several antibiotics.

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“…reported in the literature (approximately 0.15% to 7.7%) (2,12,23). Currently, we have a high rate of SSI (9.41%), when antimicrobial prophylaxis was discontinued within 24 hours after all clean neurosurgical procedures without taking into account whether EVD or other intracranial drainage systems were placed.…”

Section: Resultsmentioning

confidence: 99%

Antimicrobial prophylaxis at neurosurgical department of a major hospital in china: compare of cross sectional studies

Yang²,

He³

et al. 2014

Turkish Neurosurgery

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AIm:To compare the effects of post neurosurgical antimicrobial prophylaxis before and after the adoption of a new protocol in our department, which changed from prolonged prophylaxis to limited usage. mATERIAL and mETHods: Two cross-sectional studies were performed to compare the 24-hour antimicrobial use for all the inpatients at the neurosurgical ward 1 day before (June 30, 2011) and 1 year after (June 29, 2012) the beginning of the new rules. Student's t-test or the chisquare test were used to compare baseline characteristics and prophylactic or therapeutic antimicrobial usage between the groups. REsuLTs:The total of 391 patients enrolled consisted of 221 for June 30, 2011 as group 1 and 170 for June 29, 2012 as group 2. The baseline characteristics of the groups showed no significant difference. The prophylactic use significantly decreased in Group 2 (13.1% vs. 5.9%, p=0.018). However, total therapeutic use (10.9% vs. 18.2%, p=0.041) and the use for nosocomial infection (7.32% vs. 15.9%, p=0.009) both increased significantly in Group 2. Furthermore, therapeutic use for surgical site infections also increased significantly (3.16% vs. 9.41%, p=0.015).CoNCLusIoN: Shorter antimicrobial prophylaxis may increase post neurosurgical infection. The optimal duration of neurosurgical antimicrobial prophylaxis should be compliant with local hospital conditions and further prospective trials are required to address this issue on a procedure-specific basis.KEywoRds: Antimicrobial prophylaxis, Neurosurgery, Cross-sectional study ÖZ AmAÇ: Uzun süreli profilaksiden kısıtlı kullanıma geçecek şekilde bölümümüzde yeni bir protokolün kabullenilmesinden önce ve sonra nöroşirürji sonrasında antimikrobiyal profilaksinin etkilerini karşılaştırmak. ,9, p=0,018). Ancak nozokomiyal enfeksiyon için kullanım (%7,32 ve %15,9, p=0,009) ve total terapötik kullanım (%10,9 ve %18,2, p=0,041) değerlerinin her ikisi Grup 2'de önemli ölçüde arttı. Ayrıca, cerrahi bölge enfeksiyonları için terapötik kullanım da önemli ölçüde arttı (%3,16 ve %9,41, p=0,015). soNuÇ: Daha kısa antimikrobiyal profilaksi nöroşirürji sonrası enfeksiyonu artırabilir. Nöroşirürji için antimikrobiyal profilaksinin optimum süresi yerel hastane koşullarına uymalıdır ve bu konuyu spesifik bir temelde ele almak için ek prospektif çalışmalar gereklidir.ANAHTAR sÖZCÜKLER: Antimikrobiyel profilaksi, Nöroşirürji, Çapraz kesit çalışması

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The incidence of postoperative meningitis in neurosurgery: An institutional experience

Abstract: Meningitis remains one of the most dreaded complications of neurosurgical procedures and is common in patients with preexisting infection. Gram-negative organisms are the most common causative pathogens of postoperative meningitis.

Cited by 50 publications

References 15 publications

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

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

Infections in patients undergoing craniotomy: risk factors associated with post-craniotomy meningitis

Antimicrobial prophylaxis at neurosurgical department of a major hospital in china: compare of cross sectional studies

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