Post-neurosurgical meningitis; gram negative bacilli vs. gram positive cocci

Authors

  • Alireza Abdollahi Department of Pathology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Arash Seifi Department of Infectious Diseases, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Maryam Shadkam Department of Microbiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Mehdi Zeinalizadeh Department of Neurosurgery, Brain and Spinal Cord Injury Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Mohammadreza Salehi Department of Infectious Diseases, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Roya Yazdani Department of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Abstract:

Background: Post-neurosurgical meningitis is a significant cause of mortality and morbidity. In this study we aimed to compare the differences of clinical, laboratory features and outcomes between the post-neurosurgical meningitis caused by gram-negative bacilli (GNB) and gram-positive cocci (GPC). Methods: Cases of post-neurosurgical meningitis (with positive CSF culture) were included. After classifying patients as GNB and GPC groups, clinical and paraclinical data were compared. Results: Out of 2667 neurosurgical patients, CSF culture was positive in 45 patients. 25 (54.3%) were GNB, 19 (41.3%) GPC. The most common microorganisms were Klebsiella pneumoniae (n=14, 31.1%), Coagulase negative staphylococcus (n=8, 17.8%), Staphylococcus aureus (n=6, 13.3%), Acinetobacter baumannii (n=4, 8.9%), Pseudomonas aeruginosa (n=2, 4.4%), and Escherichia coli (n=2, 4.4%). There were no correlation between CSF Leakage, Surgical site appearance, presence of drain, Age and GCS between two groups (P=0.11, P=0.28, P=0.06, P=0.86, P=0.11 respectively). The only different laboratory indexes were ESR (86.8 mm/h vs. 59.5 mm/h, P=0.01) and PCT (13.1 ng/ml vs. 0.8 ng/ml, P=0.02) which were higher in GNB cases. 20% (n=5) of patients with GNB meningitis received preoperative corticosteroid, while none of GPC cases received (P=0.03). The median length of hospitalization for GNB and GPC cases was 56 and 44.4 days respectively (P=0.3). Conclusion: The GNB antibiotic coverage should be designed more carefully in post-neurosurgical meningitis especially in patients with recent corticosteroid therapy and elevated ESR and procalcitonin.

Upgrade to premium to download articles

Sign up to access the full text

Already have an account?login

similar resources

Meningitis Caused by Atypical Gram-negative Cocci.

Gram-negative cocci found in samples of purulent spinal fluid during routine laboratory examinations are apt to be reported as meningococci without further confirmation. While the meningococcus no doubt is the most common gram-negative coccus associated with acute meningitis, there are many others which play a r6le, particularly in sporadic cases. Error in diagnosis is also apt to occur in cert...

full text

GRAM NEGATIVE BACILLI IN BURNS

In a period of nine months, 225 strains of Gram-negative bacilli isolated from burns were identified by a variety of tests in two burn centers in Tehran. The most common species were Pseudomonas aeruginosa, Pseudomonas fluorescens, Escherichia coli, Enterobacter agglomerans, Enterobacter cloacae and Klebsiella pneumoniae. Many strains of acinetobacter spp, providencia spp, proteus spp, ser...

full text

Gram-positive Cocci: Staphylococci

full text

Gram-positive anaerobic cocci.

Gram-positive anaerobic cocci (GPAC) are a heterogeneous group of organisms defined by their morphological appearance and their inability to grow in the presence of oxygen; most clinical isolates are identified to species in the genus Peptostreptococcus. GPAC are part of the normal flora of all mucocutaneous surfaces and are often isolated from infections such as deep organ abscesses, obstetric...

full text

Antimicrobial Susceptibility Profiles of Gram- Negative Bacilli and Gram-Positive Cocci Isolated from Cancer Patients in Libya

Title: Antimicrobial Susceptibility Profiles of Gram-Negative Bacilli and Gram-Positive Cocci Isolated from Cancer Patients in Libya. Background: Due to defects in their immunity cancer patients are prone to serious infections with substantial morbidity and mortality. However, there is lack of information on the microbial and antimicrobial susceptibility profiles of microorganisms associated wi...

full text

Aerobic Gram-Negative Bacilli

A total of 434 clinical aerobic gram-negative bacillary isolates were tested against LY127935, a new 1-oxa cephalosporin, and compared with other cephalosporins, penicillins, and aminoglycosides by a broth microdilution technique. Cefotaxime (HR756), a new semisynthetic cephalosporin, and LY127935 were more active, and showed lower minimun inhibitory concentrations (rantes, -O.12 to 2.0 ,ug/ml)...

full text

My Resources

Save resource for easier access later

Save to my library Already added to my library

{@ msg_add @}


Journal title

volume 13  issue 3

pages  2- 0

publication date 2022-06

{@ msg @}

By following a journal you will be notified via email when a new issue of this journal is published.

Keywords

Hosted on Doprax cloud platform doprax.com

copyright © 2015-2023