Prevalence and antibiotic resistance of bacteria isolated from the cerebrospinal fluid of neurosurgical patients at Peking Union Medical College Hospital

Abstract

BackgroundPostoperative central nervous system infections (PCNSIs) represent a serious complication, and the timely use of antibiotics guided by the identification of the causative pathogens and their antibiotic sensitivities is essential for treatment. However, there are little data regarding the prevalence of PCNSI pathogens in China. The aim of this study is to investigate the features of pathogens in patients with PCNSIs, which could help clinicians to choose the appropriate empirical antibiotic therapy.MethodsWe retrospectively examined the positive CSF cultures in patients who underwent craniotomy between January 2010 and December 2015. We collected data, including demographic characteristics, type of neurosurgery, laboratory data, causative organisms and antimicrobial susceptibility testing results.ResultsA total of 62 patients with 90 isolates out of 818 patients with 2433 CSF culture samples were available for data analysis. The estimated incidence and culture-positive rate of PCNSIs were approximately 0.9 and 7.5%, respectively. The predominant organism was coagulase-negative staphylococci, of which most were methicillin-resistant coagulase-negative staphylococci (MRCoNS). All were susceptible to vancomycin, linezolid, rifampicin and amoxicillin-clavulanate. Acinetobacter baumannii was the most frequent causative Gram-negative agent and was resistant to 12 out of 18 antimicrobials tested. The sensitivity rates for tigecycline and minocycline were only 40 and 33%, respectively.ConclusionPCNSIs could lead to high mortality. Although the MRCoNS were the predominant organism, the management of Acinetobacter baumannii was a major clinical challenge with few effective antimicrobials in PCNSIs.Electronic supplementary materialThe online version of this article (10.1186/s13756-018-0323-3) contains supplementary material, which is available to authorized users.

A retrospective study of prevalence and antibiotic resistance of bacteria isolated from the cerebrospinal fluid of neurosurgical patients in a Shanghai tertiary hospital

“…Our study demonstrated Gram-positive bacteria was the most common organism, accounting for approximately 56% of the total isolates. This result was consistent with previous studies [12,18,19]. On the contrary, Aishwarya et al from India reported the proportion of Gram-negative bacteria causing PCNSIs was even as high as 91.6% [20].…”

Application of combined cerebrospinal fluid physicochemical parameters to detect intracranial infection in neurosurgery patients

“…This study showed that gram-positive bacteria were main infectious bacteria after intracranial surgery, which was consistent with that in the literatures [8,9]. Our study proved that coagulase-negative staphylococcus (CNS) were the most common bacteria, accounting for 41.6% of all infection pathogens, followed by 3.2% of Streptococcus viride and 3.2% of Staphylococcus aureus.…”

A combined strategy for postoperative patients with central nervous system infections caused by XDR/PDR Acinetobacter baumannii: a retrospective study

“…PCNSIs caused by AB are still a serious but rare condition. In the present research, the morbidity was approximately 0.17% and accounted for 44.4% of the gram-negative organisms (7), which was similar to the findings of previous studies (22). The mortality was reported to be over 30% in some previous studies and even over 70% when the isolates were resistant to carbapenems (8), which are higher rates than that found in our study (25%).…”

“…These findings may be related to the following three points. First, approximately half of the neurosurgery operations at our hospital involved the endonasal transsphenoidal approach, and the percentage involving PCNSIs was also nearly 50%, as previously reported (7). Second, CSF rhinorrhea, a complication of the surgery, is an important risk factor in PCNSIs (10).…”

“…The patients were identified by reviewing CSF AB positive culture isolates from neurosurgery department via a computerized log containing records, as our team previous reported (7). The cultures were analyzed by the microbiology laboratory of the hospital using the BioMerieux API or VITEK System.…”