Mixed infection in adult post-neurosurgical bacterial meningitis: a hospital-based study.

December 19, 2015 at 10:18 pm

Biomed J. 2013 Nov-Dec;36(6):295-303.

Lai WA, Lu CH, Chang WN1.

Author information

1Department of Family Medicine and Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Abstract

BACKGROUND:

Post-neurosurgical (post-NS) adult bacterial meningitis (ABM) with mixed infection is rarely examined solely in the literature.

METHODS:

The clinical features and laboratory data of post-NS ABM patients with mixed infection were included for analysis.

RESULTS:

Totally 170 post-NS ABM cases were identified and 18 (11 men and 7 women, aged 20-77 years, median = 57.5) of them had a mixed infection. A total of 45 bacterial strains including 34 Gram-negative [Gm(-)] strains and 11 Gram-positive [Gm(+)] strains were isolated. Of the implicated pathogens, Escherichia coli, Acinetobacter, Pseudomonas, and Klebsiella spp. were the common Gm(-) strains, while staphylococcal, streptococcal, and enterococcal strains were the common Gm(+) strains. Compared with the post-NS ABM cases with monomicrobial infection, those with mixed infection had a lower cerebrospinal fluid (CSF) white blood cell count. The mortality rate of post-NS ABM cases was 33.3% (6/18) without significant clinical and laboratory difference between the fatal and non-fatal groups.

CONCLUSION:

Mixed infection is not uncommon in post-NS ABM (10.6%, 18/170), and its mortality rate is high. Seventy-six percent of the implicated bacterial pathogens belonged to Gm(-) strains, while the other 24% were Gm(+) strains. The clinical and laboratory features of ABM with mixed infection are not unique; its diagnosis can only be confirmed by a positive CSF culture.

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http://www.biomedj.org/temp/BiomedJ366295-4123927_112719.pdf

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Epidemiología, Health Care-Associated Infections, Infecciones del SNC, Infecciones nosocomiales, Metodos diagnosticos, Resistencia bacteriana, Sepsis. Tags: .

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