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Analysis of microbial etiology and mortality in patients with brain abscess

Kashi N Prasad1, Asht Mangal Mishra, Deepti Gupta

  • 1Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014, India. knprasad@sgpgi.ac.in

The Journal of Infection
|January 27, 2006
PubMed
Abstract

Insights

Brain abscess remains a serious infection. Prompt pus culture and Gram stain improve diagnosis, with Gram-negative infections requiring urgent management due to higher mortality.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Microbiology

Background:

  • Brain abscess is a life-threatening central nervous system infection.
  • Despite advancements, mortality rates remain significant.
  • Understanding predisposing factors and microbial profiles is crucial for effective treatment.

Purpose of the Study:

  • To identify predisposing factors for brain abscess.
  • To determine the microbiological profile of brain abscess infections.
  • To analyze mortality rates in relation to identified infection types.

Main Methods:

  • A prospective study involving 118 patients over 8 years (1997-2004).
  • Aspirated pus was immediately cultured using automated BACTEC PLUS+ aerobic and anaerobic media.
  • Predisposing factors and patient mortality were recorded and correlated with microbiological findings.

Main Results:

  • Predisposing factors were found in 79.7% of patients, with otogenic infection being most common (31.4%).
  • Microorganisms were detected in 81.4% of cases; common isolates included Viridans streptococci, Staphylococcus aureus, and anaerobes.
  • Overall mortality was 14.4%, with significantly higher mortality in Gram-negative infections (30%) compared to Gram-positive infections (9.5%).

Conclusions:

  • Immediate culture of pus in automated systems provides excellent diagnostic yield.
  • Gram stain combined with culture aids neurosurgeons in rational treatment planning.
  • Patients with Gram-negative brain abscesses require specialized management due to increased mortality risk.

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