Open AccessEtiology, Incidence And Risk Factors For Meningitis After Craniotomy
Author(s) -
Gregory Lauar e Souza,
Handerson Dias Duarte de Carvalho,
Nicole Meireles Sacco,
Lucca Gontijo Giarola,
Estevão Urbano Silva,
Bráulio Roberto Gonçalves Marinho Couto
Publication year - 2021
Language(s) - English
Resource type - Conference proceedings
DOI - 10.5327/1516-3180.278
Subject(s) - medicine , meningitis , acinetobacter baumannii , incidence (geometry) , etiology , craniotomy , mortality rate , risk factor , pediatrics , surgery , pseudomonas aeruginosa , biology , physics , bacteria , optics , genetics
Background: Meningitis after craniotomy can cause devastating outcomes. Objectives: Estimate the risk of meningitis after craniotomy (MAC). Find the most prevalent pathogens. Assess the impact of meningitis over length of stay and mortality. Find the main risk factor for MAC. Design and setting: Multicentric, longitudinal and quantitative analysis of data collected between 2013-2017 from nine different hospitals from Minas Gerais, Brazil. Methods: Surveillance data was based on NHSN/CDC protocols. Observed outcomes were meningitis, hospital death and total length of stay. Twentythree variables were analyzed in Epi-Info in a two-tailed statistical test with a significance level of 5%. Results: 4,549 patients were analyzed. Risk of MAC was 1.9% (95%CI=1.6%; 2.4%). The mortality rate in patients without infection was 9%, increasing to 33% in infected patients (P<0.01). Length of hospital stay (HS) in uninfected patients (in days): mean=18, median=7, standard deviation=36. HS in infected patients: mean=56, median=37, standard deviation=63 P<0.001).The duration of the procedure ≤4 hours presented a 1.5% risk of MAC compared to 2.5% versus ≥4 hours (RR=1.7; P=0.041). From 88 MAC cases, pathogen was identified in 68 (77%): K.pneumoniae (20%), S.aureus (16%), A.baumannii (13%), P.aeruginosa (9%), Staphylococcus sp . (8%), Acinetobacter sp. (7%), S.epidermidis (5%) among others (20%).Conclusion: MAC risk was 1.9%. Mortality rate was high compared to literature. Meningitis caused threefold increase on HS. Procedure duration ≥4 hours was the main risk factor, presenting RR of 1.7. The most prevalent etiologic agents were K.pneumoniae and S.aureus. Considering the findings, infectious surveillance is paramount for patient safety.