Epidemiological and lethal risk factors of Klebsiella pneumoniae infection in neurosurgical patients

Abstract

Objective We performed a retrospective study to determine the epidemiological characteristics of Klebsiella pneumoniae infection after neurosurgery and to elucidate the risk. Methods Patients who underwent neurosurgery between January 2012 and December 2016 were included.Demographic, clinical, laboratory, and microbiological data were systemically recorded.17 clinical trials and 7 clinical laboratory indicators were evaluated as risk factors for meningitis. Results Forty-five cases of neurosurgery patients led to K. pneumoniae infection were analyzed, K.pneumoniae ESBLs production ratio is 37.8%(17/45), the sensitivity rate of carbapenem antibiotics was more than 80.0%(36/45). The patients were mainly in the north of China with an average age of 36.3±18.3 years old and a male ratio of 53.3%(24/45). The highest proportion of patients are pituitary adenoma and glioblastoma and the mortality rate was 22.2%(10/45). The mean length of hospital stay was 29.2±13.7 days, and the most likely to develop K. pneumoniae were 7.8±6.9 days after neurosurgery.The ICU occupancy rate was 51.1%(23/45). Chi-square test showed that older age (>50 years old) and sepsis were risk factors for death from K. pneumoniae infection after neurosurgery.Multivariate logistic analysis showed that the risk of infection was associated with the incidence of sepsis (OR 16.199, P=0.010). There were no statistically significant differences between the survival and death patients by seven laboratory tests(P>0.05). Conclusion The infection of neurosurgery caused by K. pneumoniae has a high mortality rate.Among them, concurrent sepsis is the lethal risk factor of infection.Clinically, identification of the risk factors as soon as possible will help physicians to improve patient care and improve the surgical success. Key words: Postoperative infection; Klebsiella pneumoniae; Risk factors; Neurosurgery