Analysis of pathogens and antibacterial spectrum of meningtis and/or bacteremia after trans-sphenoidal pituitary adenomectomies / 基础医学与临床

ABSTRACT

Objective To evaluate the incidence and microbiology profile of infectious complications ( namely menin-gitis and/or bacteremia ) after trans-sphenoidal pituitary adenomectomies ( TSPA ) .Methods All hospitalized patients undergoing TSPA in Dept .Neurosurgery of Peking Union Medical College Hospital ( PUMC) between January 2012 and December 2016 were retrospective recorded .Results The incidence of postoperative meningitis and/or bacteremia was 1.2%( 59/5098) .27 cases of meningitis were documented for a total of 41 isolates, 26 cases of bacteremia for 34 isolates, and 6 cases of coinfection.Gram-positive organisms predominated (27 cases, 65.9%) in meningitis, among which Coagulase-negative staphylococci were the main isolates (14 cases).The most common organisms causing bacteremia were Gram-negative organisms (25 case,73.5%),including Klebsiella pneu-monia ( 9 cases ) , Enterobacter aerogenes ( 7 cases ) and Escherichia coli ( 5 cases ) , all of which were sensitive to amikacin, imipenem and meropenem .Fifty-two patients were cured after antibiotic treatment , whereas 7 died.The morality in patients with meningitis was relatively lower than those with bacteremia (21.2%vs 3.1%,P<0.001). Conclusions Postoperative meningitis and/or bacteremia can occur after TSPA .They differ in etiology profile and prognosis , and should be treated with proper antibiotics according to the drug resistance .