Longitudinal Analysis of Risk Factors for Clinical Outcomes of Enterobacteriaceae Meningitis/Encephalitis in Post-Neurosurgical Patients: A Comparative Cohort Study During 2014-2019
Our study is a retrospective observational study conducted in one of the largest clinical centers of neurosurgery in China. We aimed to investigate the antimicrobial susceptibility patterns of the isolates responsible for nosocomial meningitis/encephalitis in post-neurosurgical patients. Meanwhile,...
Saved in:
Published in | Infection and drug resistance Vol. 13; pp. 2161 - 2170 |
---|---|
Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
New Zealand
Dove Medical Press Limited
01.01.2020
Taylor & Francis Ltd Dove Dove Medical Press |
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | Our study is a retrospective observational study conducted in one of the largest clinical centers of neurosurgery in China. We aimed to investigate the antimicrobial susceptibility patterns of the
isolates responsible for nosocomial meningitis/encephalitis in post-neurosurgical patients. Meanwhile, we tried to evaluate the risk factors for mortality following
meningitis/encephalitis.
Medical data on clinical characteristics, antibiotic susceptibilities, and mortality were reviewed until patients' discharge or death in the hospital. Data for a total of 164 cerebrospinal fluid (CSF) infection cases due to
after neurosurgery were collected between January 2014 and November 2019 in order to identify risk factors affecting the outcome. Kaplan-Meier survival analysis and multivariable Cox proportional hazard models were applied.
In this study, a total of 2416 neurosurgical meningitis/encephalitis cases were reported between 2014 and 2019.
accounted for 7.3% (176/2416) of all the bacterial infections. Of them, 164
isolates were available to divide into two groups according to the final outcome of whether the patient died or survived. In total, 38 patients died (23.2%) and 126 patients survived (76.8%). The most frequent infecting species was
(47.0%, 77/164). Fourteen-day and 30-day mortality rates were 7.9% (13/164) and 15.2% (25/164). Kaplan-Meier survival analysis revealed that the risk factors of
meningitis/encephalitis that resulted in poor outcomes included comorbidities, Glasgow Coma Scale (GCS) score, sepsis, intensive care unit (ICU) admission, extended-spectrum beta-lactamase (ESBL)-producing
, and ventilation. A GCS score of less than or equal to 8 (P=0.04, HR 2.562) was identified to be a significant risk factor for mortality according to the multivariable Cox proportional hazards model.
In-hospital mortality caused by
meningitis/encephalitis in neurosurgery was high. A GCS score of ≤8 was an independent risk factor for mortality following
meningitis/encephalitis in post-neurosurgical patients. |
---|---|
Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 These authors contributed equally to this work |
ISSN: | 1178-6973 1178-6973 |
DOI: | 10.2147/IDR.S252331 |