Hospital-acquired bacterial meningitis in neurosurgical patients

1977 ◽  
Vol 46 (4) ◽  
pp. 494-500 ◽  
Author(s):  
Frederick J. Buckwold ◽  
Roger Hand ◽  
Robert R. Hansebout
Keyword(s):  
Staphylococcus Epidermidis ◽  
Skull Fracture ◽  
Cerebrospinal Fluid Leak ◽  
Enteric Bacteria ◽  
Gram Negative ◽  
Content Type ◽  
Etiologic Agents ◽  
Neurosurgical Patients ◽  
Fluid Leak ◽  
Hospital Acquired

✓ The authors review 23 cases of hospital-acquired meningitis occurring over a 15-year period in neurosurgical patients. Factors associated with the development of meningitis include recent craniotomy, cerebrospinal fluid leak, the presence of ventricular or lumbar drainage tubes, and skull fracture. Four cases were caused by Staphylococcus epidermidis; one of these patients died. In 19 cases, Gram-negative enteric bacteria were the etiologic agents, most commonly members of the Klebsiella-Enterobacter-Serratia group. Eleven 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.

scholarly journals High-Quality Complete Genome Sequences of Three Pseudomonas aeruginosa Isolates Retrieved from Patients Hospitalized in Intensive Care Units

2019 ◽  
Vol 8 (9) ◽  
Author(s):  
Bárbara Magalhães ◽  
Laurence Senn ◽  
Dominique S. Blanc
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Genome Sequences ◽  
High Quality ◽  
Gram Negative ◽  
Content Type ◽  
Hospital Acquired Infections ◽  
Hospital Acquired ◽  
High Quality Genome

Pseudomonas aeruginosa is one of the major Gram-negative pathogens responsible for hospital-acquired infections. Here, we present high-quality genome sequences of isolates from three P. aeruginosa genotypes retrieved from patients hospitalized in intensive care units.

Biologically inert synthetic dural substitutes

1990 ◽  
Vol 73 (6) ◽  
pp. 936-941 ◽  
Author(s):  
Damianos E. Sakas ◽  
Komporn Charnvises ◽  
Lawrence F. Borges ◽  
Nicholas T. Zervas
Keyword(s):  
Foreign Body ◽  
Cerebrospinal Fluid Leak ◽  
Dural Defect ◽  
Artificial Membranes ◽  
Content Type ◽  
Dural Graft ◽  
Polyurethane Film ◽  
Foreign Body Reactions ◽  
Fluid Leak ◽  
Carbonate Film

✓ Two types of artificial membranes, a medical-grade aliphatic polyurethane and a polysiloxane-carbonate block copolymer, were tested as substitutes for dura in 24 and 12 rabbits, respectively. The films were placed either epidurally, subdurally, or as dural grafts in equal subgroups of animals. The postoperative course was uneventful with no manifestations of convulsive disorder or cerebrospinal fluid leak. The animals were sacrificed 3, 6, or 9 months after implantation of the artificial membranes. Both types of artificial membranes were easily removed from the underlying nervous and the other surrounding tissues. The histological examination failed to reveal adhesions, neomembrane formations, or any type of foreign body reactions to the polyurethane film. The implantation of the polysiloxane-carbonate film caused no reaction when it was applied epidurally. As a dural graft, the polysiloxane-carbonate copolymer induced the formation of a thin neomembrane of one to two layers of fibroblasts which formed a watertight seal of the dural defect. A similar thin neomembrane was found to encase this artificial membrane in the group of animals in which it was implanted subdurally. There was no foreign body reaction to the polysiloxane-carbonate film. The authors conclude that these materials hold promise as dural substitutes or in the prevention of spinal dural scarring, and should be evaluated clinically.

scholarly journals Severe and persistent coronavirus disease 2019 cough resulting in bone flap displacement and pseudomeningocele

2021 ◽  
Vol 12 ◽  
pp. 348
Author(s):  
Juan Silvestre Grecia Pascual ◽  
Kevin Ivan Peñaverde Chan ◽  
Kathleen Joy Ong-Lopez Khu
Keyword(s):  
Postoperative Morbidity ◽  
Cerebrospinal Fluid Leak ◽  
Symptomatic Treatment ◽  
Underlying Disease ◽  
Bone Flap ◽  
Increased Intracranial Pressure ◽  
Neurosurgical Patients ◽  
Fluid Leak ◽  
Increased Icp ◽  
Pathophysiologic Mechanisms

Background: Cough is one of the most common symptoms of coronavirus disease 2019 (COVID-19) infection. This relatively benign symptom may lead to serious sequelae, especially in postoperative neurosurgical patients. Case Description: Here, we report a case of bone flap displacement, pseudomeningocele formation, and consequent cerebrospinal fluid leak in a patient with COVID-19 infection who recently underwent craniotomy for excision of cerebral metastasis. We highlight the pathophysiologic mechanisms of cough that may cause increased intracranial pressure (ICP), leading to the postoperative morbidity. Conclusion: Aside from additional risks to the patient’s health and increased treatment costs, these complications also lead to subsequent delays in the management of the underlying disease. Symptomatic treatment of cough is advised to prevent complications resulting from increased ICP.

Transesophageal echocardiography: a simple method for monitoring the patency of ventriculoatrial shunts

1991 ◽  
Vol 74 (6) ◽  
pp. 1018-1020 ◽  
Author(s):  
Luc Calliauw ◽  
Johan Vandenbogaerde ◽  
Okito Kalala ◽  
Jacques Caemaert ◽  
Frédéric Martens ◽  
...  
Keyword(s):  
Transesophageal Echocardiography ◽  
Cerebrospinal Fluid Leak ◽  
Early Experience ◽  
Accurate Assessment ◽  
Ventriculoatrial Shunt ◽  
Simple Method ◽  
Content Type ◽  
Incidental Discovery ◽  
The Right ◽  
Fluid Leak

✓ A new method for evaluating the patency of a ventriculoatrial shunt is described, and early experience with it is reported. Transesophageal echocardiography can demonstrate a cerebrospinal fluid leak in the right atrium through the atrial tip of a shunting device. This capability was an incidental discovery, and since then the accuracy of the technique in evaluating the patency of a ventriculoatrial shunt has been prospectively studied in 20 observations of 16 patients. The method proved to be accurate in 90% to 100% of cases. It is concluded that transesophageal echocardiography offers a rapid and accurate assessment of ventriculoatrial shunt function, is well tolerated, and is easy to perform.

scholarly journals Antimicrobial Susceptibilities of Aerobic and Facultative Gram-Negative Bacilli from Intra-abdominal Infections in Patients from Seven Regions in China in 2012 and 2013

2015 ◽  
Vol 60 (1) ◽  
pp. 245-251 ◽  
Author(s):  
Hui Zhang ◽  
Qiwen Yang ◽  
Kang Liao ◽  
Yuxing Ni ◽  
Yunsong Yu ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Carbapenem Resistance ◽  
Fourth Generation ◽  
Central Laboratory ◽  
Broth Microdilution ◽  
Gram Negative ◽  
Content Type ◽  
E Coli ◽  
Abdominal Infections ◽  
Hospital Acquired

ABSTRACTTo evaluate the antimicrobial susceptibility of Gram-negative bacilli that caused hospital-acquired and community-acquired intra-abdominal infections (IAIs) in China between 2012 and 2013, we determined the susceptibilities to 12 antimicrobials and the extended-spectrum β-lactamase (ESBL) statuses of 3,540 IAI isolates from seven geographic areas in China in a central laboratory using CLSI broth microdilution and interpretive standards. Most infections were caused byEscherichia coli(46.3%) andKlebsiella pneumoniae(19.7%). Rates of ESBL-producingE. coli(P= 0.031),K. pneumoniae(P= 0.017), andProteus mirabilis(P= 0.004) were higher in hospital-acquired IAIs than in community-acquired IAIs. Susceptibilities of enterobacteriaceae to ertapenem, amikacin, piperacillin-tazobactam, and imipenem were 71.3% to 100%, 81.3% to 100%, 64.7% to 100%, and 83.1% to 100%, respectively, but imipenem was ineffective againstP. mirabilis(<20%). Although most ESBL-positive hospital-acquired isolates were resistant to third- and fourth-generation cephalosporins, the majority were susceptible to cefoxitin (47.9% to 83.9%). Susceptibilities of ESBL-positive isolates to ampicillin-sulbactam (<10%) were low, whereas susceptibilities to ciprofloxacin (0% to 54.6%) and levofloxacin (0% to 63.6%) varied substantially. The prevalences of cephalosporin-susceptibleE. coliandK. pneumoniaewere higher in the northeastern and southern regions than in the central and eastern regions, reflecting the ESBL-positive rates in these areas, and were lowest in the Jiangsu-Zhejiang (Jiang-Zhe) area where the rates of carbapenem resistance were also highest. Ertapenem, amikacin, piperacillin-tazobactam, and imipenem are the most efficacious antibiotics for treating IAIs in China, especially those caused byE. coliorK. pneumoniae. Resistance to cephalosporins and carbapenems is more common in the Jiang-Zhe area than in other regions in China.

scholarly journals Chitosan Augments Photodynamic Inactivation of Gram-Positive and Gram-Negative Bacteria

2011 ◽  
Vol 55 (5) ◽  
pp. 1883-1890 ◽  
Author(s):  
Tsuimin Tsai ◽  
Hsiung-Fei Chien ◽  
Tze-Hsien Wang ◽  
Ching-Tsan Huang ◽  
Yaw-Bee Ker ◽  
...  
Keyword(s):  
Staphylococcus Epidermidis ◽  
Light Exposure ◽  
Gram Negative Bacteria ◽  
Photodynamic Inactivation ◽  
Gram Positive ◽  
Gram Negative ◽  
Content Type ◽  
Gram Positive Bacteria ◽  
Microbial Infections ◽  
Promising Treatment

ABSTRACTAntimicrobial photodynamic inactivation (PDI) was shown to be a promising treatment modality for microbial infections. This study explores the effect of chitosan, a polycationic biopolymer, in increasing the PDI efficacy against Gram-positive bacteria, includingStaphylococcus aureus,Staphylococcus epidermidis,Streptococcus pyogenes, and methicillin-resistantS. aureus(MRSA), as well as the Gram-negative bacteriaPseudomonas aeruginosaandAcinetobacter baumannii. Chitosan at <0.1% was included in the antibacterial process either by coincubation with hematoporphyrin (Hp) and subjection to light exposure to induce the PDI effect or by addition after PDI and further incubation for 30 min. Under conditions in which Hp-PDI killed the microbe on a 2- to 4-log scale, treatment with chitosan at concentrations of as low as 0.025% for a further 30 min completely eradicated the bacteria (which were originally at ∼108CFU/ml). Similar results were also found with toluidine blue O (TBO)-mediated PDI in planktonic and biofilm cells. However, without PDI treatment, chitosan alone did not exert significant antimicrobial activity with 30 min of incubation, suggesting that the potentiated effect of chitosan worked after the bacterial damage induced by PDI. Further studies indicated that the potentiated PDI effect of chitosan was related to the level of PDI damage and the deacetylation level of the chitosan. These results indicate that the combination of PDI and chitosan is quite promising for eradicating microbial infections.

Cerebral vasospasm following intracranial hypotension caused by cerebrospinal fluid leak from an incidental lumbar durotomy

2005 ◽  
Vol 102 (1) ◽  
pp. 152-155 ◽  
Author(s):  
Claudia Chaves ◽  
Stephen R. Freidberg ◽  
Grace Lee ◽  
Vasilios Zeris ◽  
Sarah Ries ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebral Vasospasm ◽  
Intracranial Hypotension ◽  
Unusual Case ◽  
Cerebrospinal Fluid Leak ◽  
Dural Tear ◽  
Content Type ◽  
Incidental Durotomy ◽  
Fluid Leak ◽  
Fine Print

✓ The authors report on the unusual case of a patient with intracranial hypotension following an incidental durotomy complicated by an extensive but reversible cerebral vasospasm. Despite the dural tear repair and correction of the intracranial hypotension, the vasospasm ran its course. The precise mechanism of the cerebral vasospasm in this patient is unclear.

Gram-negative bacillary meningitis in neurosurgical patients

1983 ◽  
Vol 59 (4) ◽  
pp. 634-641 ◽  
Author(s):  
Giorgio Mombelli ◽  
Jean Klastersky ◽  
Lyne Coppens ◽  
Didier Daneau ◽  
Yves Nubourgh
Keyword(s):  
Nosocomial Infection ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Gram Negative ◽  
Content Type ◽  
Optimum Treatment ◽  
Results Of Treatment ◽  
Neurosurgical Patients ◽  
Fine Print

✓ The authors report 34 cases of Gram-negative bacillary meningitis related to traumatic cranial lesions or neurosurgery observed between 1973 and 1980 at two neurosurgical units (Institut J. Bordet, Brussels, and Inselspital, Bern). As a typical nosocomial infection, meningitis developed after prolonged hospitalization in most patients, and was mainly due to highly resistant organisms, such as P. aeruginosa and Klebsiella sp. At least 65% of the patients were colonized with the pathogen responsible for the meningitis before the onset of the infection. Ventriculitis, including four cases of ventricular empyema, complicated meningitis in all the 17 patients in whom a ventricular tap was performed. The results of treatment were unsatisfactory. Fifty percent of the patients were cured of their infection, but only 30% survived; 15% of the patients died within 48 hours following diagnosis. The optimum treatment of postsurgical Gram-negative meningitis remains in doubt. The choice of initial antibiotics should take into account the sensitivity patterns of colonizing microorganisms. Chloramphenicol is ineffective against most pathogens commonly involved in this infection. Intrathecal aminoglycosides may fail in the presence of ventriculitis. Intraventricular aminoglycosides are probably justified in critically ill patients. The role of the newer cephalosporins and of co-trimoxazole remains to be defined.

scholarly journals In Vitro Activity of Ceftaroline against Gram-Positive and Gram-Negative Pathogens Isolated from Patients in Canadian Hospitals in 2009

2011 ◽  
Vol 55 (6) ◽  
pp. 2837-2846 ◽  
Author(s):  
James A. Karlowsky ◽  
Heather J. Adam ◽  
Melanie R. DeCorby ◽  
Philippe R. S. Lagacé-Wiens ◽  
Daryl J. Hoban ◽  
...  
Keyword(s):  
Staphylococcus Epidermidis ◽  
Klebsiella Oxytoca ◽  
Canadian Hospital ◽  
Gram Positive ◽  
Gram Negative ◽  
Content Type ◽  
Microdilution Method ◽  
Broth Microdilution Method ◽  
Recent Collection

ABSTRACTThein vitroactivities of ceftaroline and comparative agents were determined for a collection of the most frequently isolated bacterial pathogens from hospital-associated patients across Canada in 2009 as part of the ongoing CANWARD surveillance study. In total, 4,546 isolates from 15 sentinel Canadian hospital laboratories were tested using the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method. Compared with other cephalosporins, including ceftobiprole, cefepime, and ceftriaxone, ceftaroline exhibited the greatest potency against methicillin-susceptibleStaphylococcus aureus(MSSA), with a MIC90of 0.25 μg/ml. Ceftaroline also demonstrated greater potency than ceftobiprole against community-associated methicillin-resistantS. aureus(MRSA) (MIC90, 0.5 μg/ml) and health care-associated MRSA (MIC90, 1 μg/ml) and was at least 4-fold more active than other cephalosporins againstStaphylococcus epidermidis; all isolates of MSSA and MRSA tested were susceptible to ceftaroline (MIC, ≤1 μg/ml). Against streptococci, includingStreptococcus pneumoniae, ceftaroline MICs (MIC90, ≤0.03 μg/ml) were comparable to those of ceftobiprole; however, against penicillin-nonsusceptible, macrolide-nonsusceptible, and multidrug-nonsusceptible isolates ofS. pneumoniae, ceftaroline demonstrated 2- to 4-fold and 4- to 16-fold more potent activities than those of ceftobiprole and ceftriaxone, respectively. All isolates ofS. pneumoniaetested were susceptible to ceftaroline (MIC, ≤0.25 μg/ml). Among Gram-negative isolates, ceftaroline demonstrated potent activity (MIC90, ≤0.5 μg/ml) againstEscherichia coli(92.2% of isolates were susceptible),Klebsiella pneumoniae(94.1% of isolates were susceptible),Proteus mirabilis(97.7% of isolates were susceptible), andHaemophilus influenzae(100% of isolates were susceptible). Ceftaroline demonstrated less potent activity (MIC90, ≥4 μg/ml) againstEnterobacterspp.,Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella oxytoca,Serratia marcescens, andStenotrophomonas maltophilia. Overall, ceftaroline demonstrated potentin vitroactivity against a recent collection of the most frequently encountered Gram-positive and Gram-negative isolates from patients attending hospitals across Canada in 2009.

scholarly journals The Vancomycin Resistance-Associated Regulatory System VraSR Modulates Biofilm Formation of Staphylococcus epidermidis in an ica -Dependent Manner

mSphere ◽  
2021 ◽  
Author(s):  
Youcong Wu ◽  
Yuanyuan Meng ◽  
Lian Qian ◽  
Baixing Ding ◽  
Haiyan Han ◽  
...  
Keyword(s):  
Staphylococcus Epidermidis ◽  
Biofilm Formation ◽  
Regulatory System ◽  
Vancomycin Resistance ◽  
Dependent Manner ◽  
Content Type ◽  
Two Component ◽  
Complex Procedure ◽  
Hospital Acquired

S. epidermidis is a leading cause of hospital-acquired catheter-related infections, and its pathogenicity depends mostly on its ability to form biofilms on implants. The biofilm formation is a complex procedure that involves multiple regulating factors. Here, we show that a vancomycin resistance-associated two-component regulatory system, VraSR, plays an important role in modulating S. epidermidis biofilm formation and tolerance to stress.

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