title: Post-craniotomy intracranial infection in patients with brain tumors: a retrospective analysis of 5723 consecutive patients.
abstract: OBJECTIVE
  To determine the risk factors for and the incidence, outcomes, and causative pathogens of post-craniotomy intracranial infection (PCII) in patients with brain tumors.
  
  
  METHODS
  A retrospective study was performed of 5723 patients with brain tumors who were surgically treated between January 2012 and December 2013 in Beijing Tiantan Hospital. The patients' demographics, pathohistological diagnoses, surgical procedures, postoperative variables, causative pathogens, and outcomes were evaluated.
  
  
  RESULTS
  The overall incidence of PCII was 6.8%, and 82.1% of all cases were diagnosed within two weeks after the craniotomy. Postoperative administration of antibiotics reduced the incidence of PCII. Independent risk factors included clean-contaminated craniotomy, prolonged operation (> 7 h), external cerebrospinal fluid (CSF) drainage/monitoring device placement, and postoperative CSF leakage. Patients ≤ 45 years old were more susceptible to infection. Compared with supratentorial tumors, tumors located in the infratentorial or intraventricular regions were more vulnerable to PCII. Gram-positive bacteria were the most common causative pathogens isolated from the CSF samples, accounting for 82.0% of the PCII cases.
  
  
  CONCLUSIONS
  Risk factors for PCII can be identified early in the perioperative period. These findings raise the possibility of improving the clinical outcomes of patients with brain tumors who undergo craniotomy.
authors.affiliation: a Department of Critical Care Medicine , Beijing Tiantan Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Zhong-Hua
authors.initials: ZH
authors.lastname: Shi
authors.affiliation: a Department of Critical Care Medicine , Beijing Tiantan Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Ming
authors.initials: M
authors.lastname: Xu
authors.affiliation: b Department of Neurosurgery , Beijing Tiantan Hospital and Beijing Neurosurgical Institute, Capital Medical University , Beijing , PR China.
authors.forename: Yong-Zhi
authors.initials: YZ
authors.lastname: Wang
authors.affiliation: a Department of Critical Care Medicine , Beijing Tiantan Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Xu-Ying
authors.initials: XY
authors.lastname: Luo
authors.affiliation: a Department of Critical Care Medicine , Beijing Tiantan Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Guang-Qiang
authors.initials: GQ
authors.lastname: Chen
authors.affiliation: c Information Center, Beijing Tiantan Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.affiliation: c Information Center, Beijing Tiantan Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.affiliation: d Department of Clinical Laboratory , Beijing Tiantan Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Ming-Zhong
authors.initials: MZ
authors.lastname: Tang
authors.affiliation: a Department of Critical Care Medicine , Beijing Tiantan Hospital, Capital Medical University , Beijing , PR China.
authors.forename: Jian-Xin
authors.initials: JX
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000601:surgery*; D065634:Cerebrospinal Fluid Leak / Q000150:complications / Q000453:epidemiology; D015331:Cohort Studies; D003399:Craniotomy / Q000009:adverse effects*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Brain tumor; causative pathogens; post-craniotomy intracranial infection; risk factors