A Follow-up Study of Cerebrospinal Fluid Cultures on the Prognosis of Neurosurgical Postoperative Meningitis Caused by Enterobacteriaceae
Objective This study aimed to explore risk factors associated with multiple follow-up cerebrospinal fluid cultures(FUCC)in patients with post-neurosurgical meningitis(PNM)caused by Enterobacteriaceae and to further investigate the impact of FUCC on patient outcomes.Methods This single-center retrospective cohort study included patients with PNM caused by Enterobacteriaceae admitted to Beijing Tiantan Hospital,affiliated with Capital Medical University,from 2012 to 2022.The study evaluated the impact of FUCC on infection-related mortality and used multivariable regression analysis to identify risk factors for all-cause mortality.Results During the study period,a total of 494 patients with PNM were enrolled.The main types of Enterobacteriaceae isolated were Klebsiella pneumoniae,Escherichia coli,Proteus mirabilis,and Serratia marcescens.Among them,44 patients died from infections.FUCC was performed in 235 patients(59.7％),and it was associated with a reduced 28-day infection-related mortality in patients with PNM caused by Enterobacteriaceae(HR=0.574,95％CI 0.338-0.972,P=0.039).Hypertension,repeat surgery,ICU admission,and assisted ventilation were identified as risk factors for infection-related mortality in patients with PNM caused by Enterobacteriaceae.Further comparisons of the 28-day mortality between the FUCC and non-FUCC groups showed a significant difference in infection-related mortality(P=0.012),with FUCC being associated with a lower short-term survival rate.A positive FUCC was not identified as a predictor of mortality(P=0.420).Conclusion The implementation of FUCC is proven to reduce infection-related mortality in patients with PNM caused by Enterobacteriaceae.The practice of FUCC can serve as an essential component of appropriate patient care and management strategies,and it is recommended that clinicians use it as a standard practice.
万方数据
维普
