Etiology and risk factors for meningitis and/or bacteremia after craniotomy for patients with glioma / 中南大学学报(医学版)

ABSTRACT

Objective:To evaluate the incidence and microbiological profile of meningitis and/or bacteremia after craniotomy in patients with glioma and analyze the risk factors relevant to postoperative meningitis.Methods:All demographic data,etiological data and clinical data for hospitalized patients who underwent craniotomy in Dept.of Neurosurgery of Peking Union Medical College Hospital between Jan.2013 to Dec.2017 were recorded.Results:The incidence of post-craniotomy meningitiswas 7.73％,bacteremia was 2.21％ and meningitis combined with bacteremia was 1.10％.The positive rate for cerebrospinal fluid culture was 78.57％.Among the 11 cases of meningitis,20 bacteria were detected,and the most common gram-positive bacteria wereepidermal Staphylococcus (3 case,15.0％),and hemolytic Staphylococcus (3 case,15.0％);the most common gram-negative one was Klebsiella pneumoniae (2 case,10.0％).Among the 5 cases of bacteremia,Klebsiella pneumoniae was the most common one (3 cases,60.0％).Most of the gram-positive bacteria were sensitive to vancomycin and were resistant to penicillin G.Most of the gram-negative bacteria were sensitive to the 3rd generation of cephalosporin and meropenem.Among all the 16 patients,13 were good in prognosis (81.3％) while 3 (18.8％) were poor in prognosis,with 2 deaths and 1 discharged automatically.Among the 11 patients with meningitis,7 patients (63.6％) were male and 7(63.6％) were older than 50 years old.The lesionsin the 6 patients located in the frontal lobe (54.5％) and the glioma in 6 patients was at WHO grade Ⅳ (54.5％).Three patients were diagnosed as diabetes before the surgery (27.3％).Conclusion:Postoperative meningitis and bacteremia can occur in patients with glioma.The pathogens and drug susceptibility are different.The risk factors for meningitis after craniotomy should be concerned before making a treatment plan.