Turkish Neurosurgery
Evaluation of Postoperative Meningitis: Comparison of Meningitis Caused by Acinetobacter spp. and Other Meningitis
Gönül Çiçek-Şentürk1, Rafet Özay2, Gülnur Kul1, Fatma Aybala Altay1, Semanur Kuzi3, Yunus Gürbüz1, Ediz Tütüncü1, Taha Eser4
1Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara,
2Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Neurosurgery, Ankara,
3Artvin State Hospital, Infection Clinic, Artvin,
4Doğubayazıt Doç. Dr. Yaşar Eryılmaz State Hospital, Neurosurgery Clinic, Ağrı,
DOI: 10.5137/1019-5149.JTN.25151-18.1
Aim:In this study, postoperative meningitis cases in our hospital between 2008-2016 were retrospectively reviewed.Material and Methods:The cases were divided in to three groups; Acinetobacter spp. meningitis(case group), non-Acinetobacter bacterial meningitis(control group 1) and culture negative meningitis(control group 2). We compared demographic, clinical, laboratory, treatment and mortality characteristics between case group and control groups. Results:In total, 112 patients were included in the study. The CSF culture results were negative in 50(44.6%) patients. Bacteria were isolated from cerebrospinal fluids(CSF) of 62(55.3 %) patients. Acinetobacter spp. was isolated from 28 (45%) patients, bacteria other than Acinetobacter spp. was detected in 34(55 %) patients. There was no statistically significant difference between thecase group and the control groups in terms of age, gender, comorbidity and operation type. In the case group, the change of treatment according to the culture result was significantly different from the control groups(p<0.001). Mortality was 55.6% in the case group, 24.2% in control group 1(p=0.013), 24% in control group 2(p=0.006). In multivariate analysis, isolation of Acinetobacter spp. from CSF culture (ORadj 5,2;95%CI:1,2-22,0, p=0,026) and inappropriate treatment(ORadj15,7;95%CI3,6-68,9, p<0.001) were found as independent risk factors for mortality. Conclusion:Postoperative meningitis especially due to Acinetobacter spp. and inappropriate empiric treatment are associated with high mortality.
Corresponding author : Gönül Çiçek-Şentürk