The causes of post-operative meningitis: the comparison of gram-negative and gram-positive pathogens

Kurtaran, Behice; Kuşçu, Ferit; Ulu, Aslıhan; İnal, Ayşe Seza; Kömür, Süheyla; Kibar, Filiz; Çetinalp, Nuri Eralp; Özsoy, Kerem Mazhar; Arslan, Yusuf; Yılmaz, Derviş; Aksu, Hasan Salih Zeki; Taşova, Yeşim

doi:10.5137/1019-5149.jtn.20575-17.1

Cited by 27 publications

(38 citation statements)

References 24 publications

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“…No existing data comparisons on this topic were found in previous literature. Demirarslan et al previously investigated antibiotic treatment, reporting significantly higher rates of antibiotic usage and studies have reported Acinetobacter as the causative agent in as many as 30% of meningitis cases (15,19). Findings from the present study are in accordance with data from such studies.…”

Section: █ Discussionsupporting

confidence: 91%

“…No differences were observed regarding symptoms or clinical findings (headache, blurred consciousness or fever) upon diagnosis of POM between case and control groups. Similar findings were reported by Kurtaran et al when comparing POM with Gram (-) and Gram (+) bacterial growth (15).…”

Section: █ Discussionsupporting

confidence: 90%

“…Gram (+) bacteria incidences in the presence of an EVD/LD. In the present study, presence of an EVD/LD was not detected as a risk factor for development of Acineto bacter meningitis (15).…”

Section: Kurtaran Et Al Observed No Difference Between Gram (-) Andcontrasting

confidence: 57%

“…No differences were detected in the leukocyte count, glucose or protein levels in CSF between case and control groups. Kurtaran et al previously reported, when comparing Gram (-) and Gram (+) agents, that blood and CSF leukocyte count and blood CRP levels were similar between both groups, whereas CSF glucose, protein and lactate levels were significantly higher in the Gram (-) group (15).…”

Section: █ Discussionmentioning

confidence: 94%

“…Metan et al, investigating Acinetobacter meningitis, reported a mortality rate of 71.4% (17). According to the literature, POM mortality rates are higher when caused by Gram (-) bacteria than Gram (+) bacteria (1,9,15). Such high mortality rates may be explained by high global rates of antimicrobial resistance in Gram (-) bacilli (17).…”

Section: Kurtaran Et Al Observed No Difference Between Gram (-) Andmentioning

confidence: 99%

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Evaluation of postoperative meningitis: comparison of meningitis caused by acinetobacter spp. and other meningitis

Şentürk

Özay²,

Kul³

et al. 2019

Turkish Neurosurgery

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AIM:To analyse postoperative meningitis (POM) after craniotomy, and to compare the clinical characteristics, treatment outcomes and mortality rates of POM that were caused by Acinetobacter spp. or other possible causes. MATERIAL and METHODS:In this study, POM cases in our hospital between 2008 and 2016 were retrospectively reviewed. Cases were divided into three groups; Acinetobacter spp. meningitis (case group), non-Acinetobacter bacterial meningitis (control group 1) and culture negative meningitis (control group 2). Demographic, clinical, laboratory features, treatment modalities and mortality rates were compared between case and control groups. RESULTS:A total of 112 patients with POM were included in the study. Cerebrospinal fluid (CSF) culture results were negative in 50 (44.6%) patients; bacteria were isolated from CSF of 62 (55.3%) patients. Acinetobacter spp. was isolated from 28 (45%) patients, while bacteria other than Acinetobacter spp. were detected in 34 (55%) patients. No significant differences were observed between case and control groups in terms of age, gender, comorbidity and operation type. For the case group, change of treatment according to culture result was significantly different from control groups (p<0.001).Mortality was 55.6% in the case group, 24.2% in control group 1 (p=0.013), and 24% in control group 2 (p=0.006). In multivariate analysis, isolation of Acinetobacter spp. from CSF culture [OR adj 5.2, 95% confidence interval (CI):1.2-22.0, p=0.026] and inappropriate treatment (OR adj 15.7, 95%CI:3.6-68.9, p<0.001) were determined to be independent risk factors for mortality. CONCLUSION:Postoperative meningitis, especially caused by Acinetobacter spp., and its inappropriate empirical treatment are associated with high mortality.

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Section: █ Discussionsupporting

confidence: 91%

Section: █ Discussionsupporting

confidence: 90%

“…Gram (+) bacteria incidences in the presence of an EVD/LD. In the present study, presence of an EVD/LD was not detected as a risk factor for development of Acineto bacter meningitis (15).…”

Section: Kurtaran Et Al Observed No Difference Between Gram (-) Andcontrasting

confidence: 57%

Section: █ Discussionmentioning

confidence: 94%

Section: Kurtaran Et Al Observed No Difference Between Gram (-) Andmentioning

confidence: 99%

See 3 more Smart Citations

Evaluation of postoperative meningitis: comparison of meningitis caused by acinetobacter spp. and other meningitis

Şentürk

Özay²,

Kul³

et al. 2019

Turkish Neurosurgery

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Intraventricular or intrathecal polymyxin B for treatment of post-neurosurgical intracranial infection caused by carbapenem-resistant gram-negative bacteria: a 8-year retrospective study

Hu,

Li,

Zhang

et al. 2024

Eur J Clin Microbiol Infect Dis

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Purpose Post-neurosurgical intracranial infection caused by carbapenem-resistant gram-negative bacteria (CRGNB) is a life-threatening complication. This study aimed to assess the current practices and clinical outcomes of intravenous (IV) combined with intraventricular (IVT)/intrathecal (ITH) polymyxin B in treating CRGNB intracranial infection. Methods A retrospective study was conducted on patients with post-neurosurgical intracranial infection due to CRGNB from January 2013 to December 2020. Clinical characteristics and treatment outcomes were collected and described. Kaplan–Meier survival and multivariate logistic regression analyses were performed. Results The study included 114 patients, of which 72 received systemic antimicrobial therapy combined with IVT/ITH polymyxin B, and 42 received IV administration alone. Most infections were caused by carbapenem-resistant Acinetobacter baumannii (CRAB, 63.2%), followed by carbapenem-resistant Klebsiella pneumoniae (CRKP, 31.6%). Compared with the IV group, the IVT/ITH group had a higher cerebrospinal fluid (CSF) sterilization rate in 7 days (p < 0.001) and lower 30-day mortality (p = 0.032). In the IVT/ITH group, patients with CRKP infection had a higher initial fever (p = 0.014), higher incidence of bloodstream infection (p = 0.040), lower CSF sterilization in 7 days (p < 0.001), and higher 30-day mortality (p = 0.005) than those with CRAB infection. Multivariate logistic regression analysis revealed that the duration of IVT/ITH polymyxin B (p = 0.021) was independently associated with 30-day mortality. Conclusions Intravenous combined with IVT/ITH polymyxin B increased CSF microbiological eradication and improved clinical outcomes. CRKP intracranial infections may lead to more difficult treatment and thus warrant attention and further optimized treatment.

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Epidemiology and antimicrobial resistance patterns of bacterial meningitis among hospitalized patients at a tertiary care hospital in Saudi Arabia: a six-year retrospective study

Alhazmi,

Alameer,

Abuageelah

et al. 2024

Eur J Clin Microbiol Infect Dis

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The causes of post-operative meningitis: the comparison of gram-negative and gram-positive pathogens

Abstract: As conclusions; in NM, Gram-negative pathogens were seen more frequently; A.baumanni was the predominant pathogen; and NM caused by Gram negatives had worse clinical and laboratory characteristic and prognostic outcome than Gram positives.

Cited by 27 publications

References 24 publications

Evaluation of postoperative meningitis: comparison of meningitis caused by acinetobacter spp. and other meningitis

Evaluation of postoperative meningitis: comparison of meningitis caused by acinetobacter spp. and other meningitis

Intraventricular or intrathecal polymyxin B for treatment of post-neurosurgical intracranial infection caused by carbapenem-resistant gram-negative bacteria: a 8-year retrospective study

Epidemiology and antimicrobial resistance patterns of bacterial meningitis among hospitalized patients at a tertiary care hospital in Saudi Arabia: a six-year retrospective study

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