Hospital-acquired bacterial meningitis in neurosurgical patients

Abstract

Cases (23) of hospital-acquired meningitis occurring over a 15 yr period in neurosurgical patients are reviewed. Factors associated with the development of meningitis include recent craniotomy, CSF leak, the presence of ventricular or lumbar drainage tubes and skull fracture. Four cases were caused by Staphylococcus epidermidis; 1 of these patients died. In 19 cases gram-negative enteric bacteria were the etiologic agents, most commonly members of the Klebsiella-Enterobacter-Serratia group; 11 of these patients died. The particular antibiotic or group of antibiotics used and the route of administration made no difference in the outcome of gram-negative bacillary meningitis.