Prevalence and Risk Factors of Bacterial Meningitis after Craniotomy in Shahid Bahonar Hospital of Kerman in 2016

Abstract

Objective: Postoperative infections of the central nervous system are common complications of neurological surgeries, which can lead to bad consequences for the patient and increase the cost of treatment. Incorrect diagnosis or treatment of meningitis after craniotomy can lead to irrecoverable disabilities. Therefore, this study tends to investigate the prevalence and risk factors of bacterial meningitis after craniotomy in Shahid Bahonar Hospital of Kerman. Methods: This was a cross-sectional, analytical, descriptive study. The statistical population was 146 patients who underwent craniotomy in Shahid Bahonar Hospital of Kerman during 2016. To find out the relationship between each risk factor and meningitis, multivariate logistic regression was used. Data was analysed by SPSS software version 16. For comparison of percentages between two groups, Chi-square test or Fisher's exact test was used. In order to compare quantitative variables between the two groups, independent t-test was used; if the data was nonparametric, U-Mann-Whitney test was used. Results: Of 77 patients, who underwent elective surgery, 5 cases (6.5%) developed bacterial meningitis; of patents that underwent emergency surgery, 8 cases (11.6%) developed bacterial meningitis. Two of 43 female patients (4.7%) and 11 of 103 male patients (10.7%) developed bacterial meningitis of patients with underlying disease, 4 (5.6%) patients developed bacterial meningitis and 9 (12%) of other patients developed bacterial meningitis. There were 4 cases of cerebrospinal fluid leakage. Of 146 patients, 13 cases (8.9%) developed bacterial meningitis, of which 5 had positive bacterial CSF culture; one case of Acinetobacter baumannii, one case of Staphylococcus Epidermidis ,one case of Streptococcus pyogenes, one case of Staphylococcus aureus and one case of Pseudomonas aeruginosa  were reported. Conclusion: It can be concluded that prevalence of bacterial meningitis increases with the increase in the number of received blood units, the presence of associated infection, the increase in duration of stay in hospital and ICU, the increase in duration of mechanical ventilation and repeated craniotomy and lower GCS.