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Mixed infection in adult post-neurosurgical bacterial meningitis: a hospital-based study

Wei-An Lai, Cheng-Hsien Lu, Wen-Neng Chang1

  • 1Department of Family Medicine and Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Biomedical Journal
|January 4, 2014
PubMed
Abstract

Insights

Mixed bacterial meningitis after neurosurgery is often caused by Gram-negative bacteria and has a high mortality rate. Diagnosis requires cerebrospinal fluid culture due to non-unique clinical features.

Area of Science:

  • Infectious Diseases
  • Neuroscience
  • Microbiology

Background:

  • Post-neurosurgical bacterial meningitis (ABM) with mixed infections is underrepresented in medical literature.
  • Understanding mixed infections is crucial for improving patient outcomes.

Purpose of the Study:

  • To analyze the clinical features and laboratory data of adult patients with post-neurosurgical ABM and mixed infections.
  • To determine the prevalence, causative pathogens, and mortality rates associated with mixed ABM post-neurosurgery.

Main Methods:

  • Retrospective analysis of 170 post-neurosurgical ABM cases.
  • Identification and characterization of bacterial strains from cerebrospinal fluid (CSF) cultures.
  • Comparison of clinical and laboratory data between mixed and monomicrobial infections.

Main Results:

  • 18 out of 170 cases (10.6%) presented with mixed ABM.
  • Gram-negative bacteria (76%) were more common than Gram-positive bacteria (24%).
  • Mixed infections showed lower CSF white blood cell counts compared to monomicrobial infections, with a high mortality rate (33.3%).

Conclusions:

  • Mixed infections are a significant concern in post-neurosurgical ABM, characterized by a high mortality rate.
  • Gram-negative pathogens dominate mixed ABM post-neurosurgery.
  • Diagnosis relies on CSF culture as clinical and laboratory findings are not distinctive.

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