A Clinical Study on Risk Factors for Postoperative Meningitis Associated with Coagulase Negative Staphylococcus Aureus in Neurosurgery
Objective To study the risk factors for postoperative meningitis associated with coagulase negative Staphylococcus aureus(CoNS)in neurosurgery,and to explore the epidemiological characteristics and treatment methods of CoNS.Methods A retrospective study was conducted for patients with post-operative meningitis in neurosurgery from June,2020 to June,2022,and a multivariate regression method was used to identify the risk factors of CoNS related post-operative meningitis in neurosurgery.Results A total of 279 neurosurgical patients with positive CoNS in cerebrospinal fluid culture were collected,accounting for 9.5％(279/2 950)of all bacterial infections after neurosurgical surgery.Among them,146 patients were diagnosed with meningitis,and 133 patients were diagnosed with contamination.The most common types of meningitis inpatients with CoNS related neurosurgery were Staphylococcus epidermidis(51.37％,75/146),Staphylococcus aureus(20.55％,30/146),and Staphylococcus hemolysis(17.81％,26/146).The drug sensitivity test showed that the resistance of CoNS to penicillin G,erythromycin,and oxacillin were 85.7％,79.6％,and 74.8％,respectively,while the sensitivity to vancomycin,tigecycline,and linezolid was 100％.Univariate analysis showed significant differences between the CoNS related postoperative meningitis group and the contaminated group in terms of craniotomy surgery,malignant tumors,surgical duration,ventricular drainage,and surgical incision type;Multivariate analysis showed that malignant tumors(95％confidence interval 1.551-5.314,P=0.001)and extraventricular drainage(95％confidence interval 1.582-5.030,P＜0.001;)were independent risk factors for postoperative meningitis related to CoNS neurosurgery.Conclusion Postoperative meningitis related to CoNS neurosurgery is closely related to various factors,including craniotomy,surgical duration,and surgical wound type.Among them,patients with malignant tumors and extraventricular drainage are independent risk factors.
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