title: Post-neurosurgical nosocomial bacterial meningitis in adults: microbiology, clinical features, and outcomes.
abstract: The clinical data of 62 adult patients who suffered post-neurosurgical nosocomial bacterial meningitis, retrospectively collected over a 16-year period, were studied. Cases were divided into two groups based on the date of presentation, the first period being 1986-1993 and the second 1994-2001. Fever and progressive consciousness disturbance were the most consistent clinical features - signs that may also be attributed to other postoperative neurosurgical problems. The common pathogens included Staphylococcus aureus, coagulase negative Staphylococcus, Pseudomonas aeruginosa, Escherichia coli, and Acinetobacter baumannii. An increase in polymicrobial infections and multi-antibiotic resistance during the second period was identified. In the first half of the study, mortality was 22%, and in the second half 36%. Adult post-neurosurgical nosocomial bacterial meningitis has become an important clinical problem. The choice of appropriate empirical antibiotics is challenging and must be guided by an awareness of the relative frequency of various pathogens and the increasing incidence of resistant strains. Although high mortality rates may, in part, be related to the primary brain pathology, early diagnosis and the timely use of antibiotics based on antimicrobial susceptibility testing are essential for survival.
authors: Department of Neurosurgery, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung, Taiwan.
authors: Kuo-Wei
authors: KW
authors: Wang
authors: Wen-Neng
authors: WN
authors: Chang
authors: Chi-Ren
authors: CR
authors: Huang
authors: Nai-Wen
authors: NW
authors: Tsai
authors: Huan-Wen
authors: HW
authors: Tsui
authors: Hung-Chen
authors: HC
authors: Wang
authors: Thung-Ming
authors: TM
authors: Su
authors: Cheng-Shyuan
authors: CS
authors: Rau
authors: Ben-Chung
authors: BC
authors: Cheng
authors: Chen-Sheng
authors: CS
authors: Chang
authors: Yao-Chung
authors: YC
authors: Chuang
authors: Po-Chou
authors: PC
authors: Liliang
authors: Yu-Duan
authors: YD
authors: Tsai
authors: Cheng-Hsien
authors: CH
authors: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification / Q000472:pathogenicity; D005260:Female; D005334:Fever / Q000382:microbiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000209:etiology* / Q000382:microbiology* / Q000401:mortality / Q000628:therapy*; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents