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 ORIGINAL ARTICLE
Year : 2008  |  Volume : 56  |  Issue : 4  |  Page : 433--437

Clinical features, laboratory data, management and the risk factors that affect the mortality in patients with postoperative meningitis


1 Department of Infectious Disease and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
2 Department of Neurosurgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
3 Department of Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey

Correspondence Address:
Ilknur Erdem
Namik Kemal Universitesi Tip Fakultesi Dekanligi, Namik Kemal Cad. No:14, 59100 Tekirdag
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.44629

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Background: Nosocomial meningitis is a rare complication following neurosurgical procedures and is associated with high morbidity and mortality. Aim: The aim of this study was to describe the clinical characteristics and the risk factors associated with mortality in patients who developed nosocomial meningitis following neurosurgical operations. Setting and design: Tertiary care hospital and an observational study. Materials and Methods: The study subjects included 2265 patients who underwent various neurosurgical operations during 2003-05. The diagnosis of nosocomial meningitis was based on the Center for Disease Control criteria. Statistical analysis: It was performed by using Statistical Package for Social Sciences for Windows 10.0 program. Results: The incidence of postoperative nosocomial meningitis was 2.7% (62 episodes in 49 patients among 2265 patients operated). Staphylococcus aureus and Acinetobacter spp. were the most frequently isolated pathogens. Of the 49 with meningitis 20 (40.8%) patients died. In the logistic regression analysis model, Glascow coma scale score less than 10 (Odds Ratio (OR): 19.419, 95% Confidence Interval (CI); 1.637-230.41, P = 0.001), and low cerebrospinal fluid glucose level (≤ 30 mg/ dL) (OR: 10.272, 95% CI; 1.273-82.854, P = 0.002), and presence of concurrent nosocomial infection (OR: 28.744, 95% CI;1.647-501.73, P =0.001) were the independent risk factors associated with mortality. Conclusion: The mortality in patients who developed meningitis was high. The high percentage of concurrent nosocomial infections was associated with a high mortality rate which was a serious problem.






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