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ORIGINAL ARTICLE
Year : 2019  |  Volume : 14  |  Issue : 3  |  Page : 834-838

Prevalence and antibiotic resistance profile of cerebrospinal fluid pathogens from neurosurgical patients from level 1 trauma center in India


1 Department of Microbiology, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
2 Department of Community Medicine, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
3 Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
4 Department of Neuro Anaesthesiology, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Purva Mathur
Department of Microbiology, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, 2nd Floor, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajns.AJNS_268_18

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Introduction: The purpose of this study was to investigate the prevalence of Postoperative central nervous system infections (PCNSIs) and antibiotic resistance profiles of causative organisms in trauma patients following neuroinvasive procedures. Materials and Methods: This was a retrospective study conducted over a period of 4 years (2013–2017). All in-patients admitted under a neurotrauma unit meeting the inclusion criteria of PCNSIs were included in the study. Surgical site infections (SSIs) were defined according to the Centers for Disease Control and Prevention 2018 (CDC) criteria. We retrospectively examined the demographic characteristics, type of neurosurgery performed, laboratory data, causative organisms, and antimicrobial susceptibility testing results of patients who had positive cerebrospinal fluid cultures following craniotomy between January 2013 and December 2017. Results: Of total 2500 patients operated during the study, 961 patients were screened for PCNSIs. The estimated prevalence (95% confidence interval) of PCNSIs which is a type of organ/space SSI was 7.2% (6.3–8.3). Males were predominantly affected (85.0%). The mean age (standard deviation) of patients was 31.9 (16.5) years. Of all the cultures sent for microbiological examination, 18.6% were positive. The proportion of Gram-negative bacteria causing PCNSIs was 91.6%. Multidrug-resistant (MDR) Acinetobacter baumannii (41%) was the most common organism isolated. Among Gram-positive bacteria, the most common organism was Staphylococcus aureus (5.5%). All the Gram-positive isolates were susceptible to vancomycin, teicoplanin, and linezolid. Conclusion: There is a high burden of PCNSI caused by MDR Acinetobacter baumannii can pose a major clinical challenge with only few antimicrobials left in the pipeline.


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