Risk factors associated with postcraniotomy meningitis: A retrospective study.

Area of Science:

• Neurosurgery
• Infectious Diseases
• Epidemiology

Background:

• Postcraniotomy meningitis (PCM) is a significant complication in neurosurgery.
• Changing patterns of infectious agents in PCM necessitate updated epidemiological data and risk assessments.

Purpose of the Study:

• To determine risk factors for PCM.
• To identify the current pattern of infectious agents causing PCM.

Main Methods:

• Retrospective case-control study conducted between January 1, 2008, and December 31, 2012.
• Reviewed 22 cases of PCM out of 4392 postcraniotomy patients.
• Assessed risk factors and identified causative pathogens from cerebrospinal fluid samples.

Main Results:

• Identified elderly patients, emergency procedures, cerebrospinal fluid leaks, external ventricular drainage, ICU admission, prolonged drain placement (>72 hours), extended surgery duration (>4.5 hours), repeat operations, trauma, and 30-day mortality as significant risk factors.
• Staphylococcus aureus (36.7%) and Acinetobacter baumannii (31.8%) were the predominant pathogens.
• Overall mortality rate for postcraniotomy patients was 5.1%.

Conclusions:

• Accurate risk assessment, early diagnosis, and appropriate antibiotic selection based on current epidemiology are crucial for reducing PCM mortality and morbidity.
• The evolving patterns of infectious agents underscore the need for ongoing research to guide clinical practice.