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Methods • Patients who had an infection after brain tumor surgery at our institution from 2010-2014 were retrospectively reviewed after IRB approval • Patients with primary surgery outside the Cleveland clinic or shunt surgery after index tumor surgery and subsequent shunt infection were excluded from study • Total of 75 patients were reviewed including infections after craniotomy (67 patients), after burr hole procedures (5 patients), and after trans-nasal operations (3 patients) • Demographic information, type of intracranial tumor and factors associated with surgery, characteristics of the infection and also re-admission within a year after discharge and mortality were evaluated Results • Age average was 51 years and 41% were females • Median interval between tumor surgery and diagnosis of infection was 1 month • 72% had post-op wound issues such as wound dehiscence, drainage and pseudomeningocele • In 10 patients both gram stain and culture were negative and treatment was performed based upon clinical findings • 26 of 75 patients (35%) had re-admissions for recurrent/resistance infection • Out of 20 patients with titanium mesh placement, 10 were readmitted for recurrent/ resistant infection (50%) • 2 patients (3%) died with 90 days of diagnosis of infection Conclusions • Staphylococcal infections (MSSA and CONS) are the most common pathogens in post-op infections of brain tumors • The infection recurrence and readmission rate among these patients is relatively high at 35%, and is even greater (50%) in the presence of titanium mesh • With aggressive and appropriate treatment (antibiotics ± wound washout) mortality within 90 days remains relatively low (3%) Factor No. of patients Percent

Post-Operative Infection After Surgery of Brain Tumors: A Five-Year Review of Common Pathogens, Presentation and Other Associated Factors