Intracranial malignant lesions correlate with the requirement for a long treatment course in postoperative central nervous system infection

Abstract

Heng Zhou, Xinghu Zhang Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China Aim: Our aim was to study the clinical features of postoperative meningitis after neurosurgery and identify the factors affecting the duration of treatment.Methods: This retrospective study assessed 283 patients with postoperative bacterial meningitis in the Neurosurgery Department of Beijing Tiantan Hospital, Beijing, People’s Republic of China, between January and December 2012. Patients’ clinical data were reviewed, and multivariate logistic regression analysis was used to identify the factors associated with a prolonged treatment course.Results: The mortality rate was 0.4% in these patients, of whom 12.4% were found with pathogens in the cerebrospinal fluid. Among the three most common pathogens detected were methicillin-resistant Staphylococcus aureus, Acinetobacter baumannii, and Pseudomonas aeruginosa. The mean treatment course was 13.5±2.1 days. Interestingly, the treatment duration for postoperative meningitis was significantly longer in patients with intracranial malignant tumors than in those with benign lesions. Single-factor analysis showed that male sex (P=0.042) and malignant (rather than benign) lesions (P<0.001) were significantly associated with prolonged treatment duration. Multivariate analysis further confirmed that malignant intracranial lesions represented an independent risk factor for prolonged treatment duration (odds ratio: 2.5962; 95% confidence interval: 1.1092–6.6134).Conclusion: The nature of the intracranial lesion is an independent risk factor for the duration of treatment in postoperative meningitis after neurosurgery. Keywords: Acinetobacter baumannii, cerebrospinal fluid, intracranial malignant tumors, methicillin-resistant Staphylococcus aureus, postoperative meningitis, Pseudomonas aeruginosa