Postoperative bacterial meningitis in intracranial neurosurgery: a retrospective analysis of 79 cases / 中华传染病杂志

ABSTRACT

ObjectiveTo investigate the incidence of bacterial meningitis in patients who underwent intracranial neurosurgery and to explore the pathogen distribution and related risk factors.MethodsThe patients were selected by cluster systematic sampling method from the patient population who underwent intracranial neurosurgery for at least one time in Huashan Hospital affiliated to Fudan University in 2008.Chi-square test and Logistic regression model were used to analyze the data.ResultsA total of 1165 patients were included in this study.Seventy-nine of them were diagnosed with bacterial meningitis,while eight of them bad positive results for bacterial culture,including 3 cases of Acinetobacter baumannii,and 1 case each of Acinetobacter lwoffii,Klebsiella pneumoniae,Staphylococcus epidermidis,Enterococcus and Streptococcus intermedius. The common neurosurgical diseases with high incidence of postoperative bacterial meningitis were neurilemmoma 15.85％(13/82),glioma 12.21％ (21/172) and hydrocephalus 10.34％ (3/29).Logistic regression analysis identified male,implant,enteral nutrition,external ventricular drainage and wound negative pressure drainage as independent risk factors for postoperative bacterial meningitis.ConclusionsPostoperative central nervous system infection is the most common and severe complication after the intracranial neurosurgery.The results highlight the importance of improving pathogen detection rate and enhancing the prevention in high risk patient populations.