Bacterial distribution of cerebrospinal fluid cultures and its effect on therapeutic efficacy in patients with severe intracranial infection after open craniotomy / 中华创伤杂志

ABSTRACT

Objective To investigate the distribution characteristics of pathogens isolated fromcerebrospinal fluid of neurosurgical patients with intracranial infection following open craniotomy and thetherapeutic effect influenced by these pathogens,in order to give a reference to the clinical treatmentmeasures.Methods A retrospective analysis was made on the pathogen distribution and therapeuticeffect of 43 patients with intracranial infection and positive cerebrospinal fluid cultures after open cranioto-my from May 2007 to May 2013.Cerebrospinal fluid was cleared using the intraventricular catheter orlumbar catheter combined with intraventricular (ventricular irrigation) or intraspinal (intrathecalirrigation) injection of antibacterial agents.Results To test bacteria in cerebrospinal fluid pathogencultures,34 cases were infected with single strain (26 Gram-positive bacteria and 8 Gram-negativebacteria) and 9 cases had mixed infection with multiple strains.Fifty-two pathogen strains were isolated,including 32 (62％) Gram-positive bacteria,18 (35％) Gram-negative bacteria,2 (4％) fungi.A totalof 29 cases were cured (67％),7 improved (16％),and 7 ineffective (16％).Conclusions Cere-brospinal fluid pathogen infection is primarily Gram-positive bacterial infection,usually staphylococcusepidermidis and staphylococcus aureus.Gram-negative pathogens are acinetobacter,klebsiella,andpseudomonas aeruginosa.Ventriculoperitoneal shunting surgery and craniocerebral surgery are often asso-ciated with mixed infection of pathogens.Ventricular irrigation allows better results than intrathecal irriga-tion.Indications of intrathecal irrigation treatment used to control intracranial infection after ventriculoper-itoneal shunting surgery and craniocerebral surgery should be strictly performed.