Clinical features, laboratory data, management and the risk factors that affect the mortality in patients with postoperative meningitis.
BACKGROUND
Nosocomial meningitis is a rare complication following neurosurgical procedures and is associated with high morbidity and mortality.


OBJECTIVE
The aim of this study was to describe the clinical characteristics and the risk factors associated with mortality in patients who developed nosocomial meningitis following neurosurgical operations.


METHODS
Tertiary care hospital and an observational study.


METHODS
The study subjects included 2265 patients who underwent various neurosurgical operations during 2003-05. The diagnosis of nosocomial meningitis was based on the Center for Disease Control criteria.


METHODS
It was performed by using Statistical Package for Social Sciences for Windows 10.0 program.


RESULTS
The incidence of postoperative nosocomial meningitis was 2.7% (62 episodes in 49 patients among 2265 patients operated). Staphylococcus aureus and Acinetobacter spp. were the most frequently isolated pathogens. Of the 49 with meningitis 20 (40.8%) patients died. In the logistic regression analysis model, Glascow coma scale score less than 10 (Odds Ratio (OR): 19.419, 95% Confidence Interval (CI); 1.637-230.41, P = 0.001), and low cerebrospinal fluid glucose level (< or = 30 mg/ dL) (OR: 10.272, 95% CI; 1.273-82.854, P = 0.002), and presence of concurrent nosocomial infection (OR: 28.744, 95% CI;1.647-501.73, P =0.001) were the independent risk factors associated with mortality.


CONCLUSIONS
The mortality in patients who developed meningitis was high. The high percentage of concurrent nosocomial infections was associated with a high mortality rate which was a serious problem.
Erdem
Ilknur
I
Department of Infectious Disease and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey. erdem_ilknur@yahoo.com
Hakan
Tayfun
T
Ceran
Nurgul
N
Metin
Fatma
F
Akcay
Seniha Senbayrak
SS
Kucukercan
Metin
M
Berkman
M Zafer
MZ
Goktas
Pasa
P
D000151:Acinetobacter Infections / Q000382:microbiology / Q000401:mortality / Q000628:therapy; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000382:microbiology / Q000401:mortality / Q000628:therapy*; D008875:Middle Aged; D011183:Postoperative Complications / Q000382:microbiology / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000382:microbiology / Q000401:mortality / Q000628:therapy