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The incidence of postoperative meningitis in neurosurgery: an institutional experience

Dwarakanath Srinivas1, H B Veena Kumari, Sampath Somanna

  • 1Department of Neurosurgery, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India. dwarakaneuro@yahoo.com

Neurology India
|April 13, 2011
PubMed
Abstract

Insights

Postoperative meningitis is a serious neurosurgical complication. Gram-negative bacteria are the most frequent cause, especially in patients with prior infections.

Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Microbiology

Background:

  • Meningitis is a significant cause of morbidity and mortality in neurosurgical patients.
  • Postoperative meningitis incidence varies widely, ranging from 0.5% to 8%.

Purpose of the Study:

  • To analyze the incidence of postoperative meningitis.
  • To determine the causative organisms and their antibiotic sensitivity patterns.

Main Methods:

  • Retrospective analysis of 18,092 neurosurgical patients from 2001-2007.
  • Inclusion of patients with culture-positive meningitis.
  • Analysis based on surgery type, organism profile, and antibiotic sensitivity.

Main Results:

  • Overall meningitis incidence was 2.2%, with a higher rate (7.7%) in patients with pre-existing infections.
  • Non-lactose fermenting Gram-negative bacilli, Pseudomonas, and Klebsiella were common pathogens.
  • Methicillin-resistant Staphylococcus aureus (MRSA) found in 2.6% of cases; 91 strains were multi-drug resistant.

Conclusions:

  • Meningitis remains a feared complication of neurosurgery, particularly in patients with pre-existing infections.
  • Gram-negative organisms are the predominant causative agents of postoperative meningitis.

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