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[Nosocomial meningitis in endoscopic transsphenoidal surgery]

O I Sharipov1, O N Ershova1, N V Kurdyumova1

  • 1Burdenko Neurosurgical Center, Moscow, Russia.

Zhurnal Voprosy Neirokhirurgii Imeni N. N. Burdenko
|August 9, 2022
PubMed

Insights

Nosocomial meningitis (NCM) is a serious risk after transsphenoidal surgery, often caused by CSF leakage. Prompt antibiotic treatment is crucial for better patient outcomes.

Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Medical Quality Indicators

Background:

  • Transsphenoidal surgery carries a risk of infectious complications, notably nosocomial meningitis (NCM).
  • NCM significantly increases hospital stay, costs, and mortality, impacting patient outcomes and reflecting healthcare quality.
  • Endoscopic transsphenoidal surgery necessitates a review of NCM prevention and management strategies.

Purpose of the Study:

  • To identify key risk factors for NCM following endoscopic transsphenoidal surgery.
  • To evaluate current antibiotic prophylaxis regimens for NCM.
  • To outline effective treatment protocols for NCM post-endoscopic transsphenoidal surgery.

Main Methods:

  • Review of existing literature on NCM in the context of transsphenoidal surgery.
  • Analysis of risk factors, including cerebrospinal fluid (CSF) leakage, obesity, diabetes, prior surgeries, and radiotherapy.
  • Examination of antibiotic prophylaxis guidelines and treatment strategies.

Main Results:

  • Identified risk factors for NCM include intraoperative and postoperative CSF leakage, obesity, diabetes mellitus, previous transsphenoidal surgeries, and radiotherapy.
  • Current guidelines for antibiotic prophylaxis duration in cases of CSF leakage, drains, or nasal packing are not standardized.
  • Antibiotic prophylaxis exceeding three days increases the risk of drug-resistant organisms.

Conclusions:

  • Immediate initiation of broad-spectrum antibiotics is recommended upon NCM detection.
  • Standardized protocols for antibiotic prophylaxis duration are needed to optimize NCM prevention.
  • Addressing identified risk factors is essential for improving patient safety after transsphenoidal surgery.
Keywords:
CSF leakagecomplicationsmeningitistranssphenoidal approach

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