{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:05:51Z","timestamp":1791295551222,"version":"4.1.0"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2015,5]]},"abstract":"\n OBJECT<\/jats:title>\n The authors performed a prospective study to define the prevalence and microbiological characteristics of infections in patients undergoing craniotomy and to clarify the risk factors for post-craniotomy meningitis.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Patients older than 18 years who underwent nonstereotactic craniotomies between January 2006 and December 2008 were included. Demographic, clinical, laboratory, and microbiological data were systemically recorded. Patient characteristics, craniotomy type, and pre- and postoperative variables were evaluated as risk factors for meningitis<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n Three hundred thirty-four procedures were analyzed (65.6% involving male patients). Traumatic brain injury was the most common reason for craniotomy. Almost 40% of the patients developed at least 1 infection. Ventilatorassociated pneumonia (VAP) was the most common infection recorded (22.5%) and\n Acinetobacter<\/jats:italic>\n spp. were isolated in 44% of the cases. Meningitis was encountered in 16 procedures (4.8%), and CSF cultures were positive for microbial growth in 100% of these cases. Gram-negative pathogens (\n Acinetobacter<\/jats:italic>\n spp.,\n Klebsiella<\/jats:italic>\n spp.,\n Pseudomonas aeruginosa<\/jats:italic>\n ,\n Enterobacter cloaceae<\/jats:italic>\n ,\n Proteus mirabilis<\/jats:italic>\n ) represented 88% of the pathogens.\n Acinetobacter<\/jats:italic>\n and\n Klebsiella<\/jats:italic>\n spp. demonstrated a high percentage of resistance in several antibiotic classes. In multivariate analysis, the risk for meningitis was independently associated with perioperative steroid use (OR 11.55, p = 0.005), CSF leak (OR 48.03, p < 0.001), and ventricular drainage (OR 70.52, p < 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Device-related postoperative communication between the CSF and the environment, CSF leak, and perioperative steroid use were defined as risk factors for meningitis in this study. Ventilator-associated pneumonia was the most common infection overall. The offending pathogens presented a high level of resistance to several antibiotics.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2014.8.jns132557","type":"journal-article","created":{"date-parts":[[2014,10,24]],"date-time":"2014-10-24T10:12:05Z","timestamp":1414145525000},"page":"1113-1119","source":"Crossref","is-referenced-by-count":149,"title":["Infections in patients undergoing craniotomy: risk factors associated with post-craniotomy meningitis"],"prefix":"10.3171","volume":"122","author":[{"given":"Irene S.","family":"Kourbeti","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, General Hospital of Chalkida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonis F.","family":"Vakis","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panayiotis","family":"Ziakas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Disease, Warren Alpert Medical School, Brown University, Providence, Rhode Island; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitris","family":"Karabetsos","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Potolidis","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, General Hospital of Volos, Greece;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvana","family":"Christou","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, General Hospital of Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Samonis","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Infectious Disease, University Hospital of Heraklion;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns132557","series-title":"Scand J Infect Dis","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1080\/00365540410027193","article-title":"Gram-negative bacillary meningitis after cranial surgery or trauma in adults","volume":"36","author":"Briggs","year":"2004"},{"key":"b2-jns132557","series-title":"Neurosurg Clin N Am","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1016\/S1042-3680(18)30669-7","article-title":"Craniotomy infections","volume":"3","author":"Blomstedt","year":"1992"},{"key":"b3-jns132557","series-title":"Am J Respir Crit Care Med","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1164\/ajrccm.165.7.2105078","article-title":"Ventilator-associated pneumonia","volume":"165","author":"Chastre","year":"2002"},{"key":"b4-jns132557","series-title":"Neurol India","doi-asserted-by":"publisher","first-page":"433","DOI":"10.4103\/0028-3886.44629","article-title":"Clinical features, laboratory data, management and the risk factors that affect the mortality in patients with postoperative meningitis","volume":"56","author":"Erdem","year":"2008"},{"key":"b5-jns132557","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.surneu.2004.04.024","article-title":"Risk factors for surgical site infections in neurosurgery patients with antibiotic prophylaxis","volume":"63","author":"Erman","year":"2005"},{"key":"b6-jns132557","series-title":"Neurol India","first-page":"134","article-title":"Nosocomial infections due to Acinetobacter baumannii in a neurosurgery ICU","volume":"49","author":"Gulati","year":"2001"},{"key":"b7-jns132557","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"48","DOI":"10.3171\/2013.3.JNS121489","article-title":"Bone flap explantation, steroid use, and rates of infection in patients with epilepsy undergoing craniotomy for implantation of subdural electrodes. 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