Trends of Intra-Cranial Bacterial Infection in Patients Requiring Emergency Neurosurgery

Background: Intra-cranial bacterial infection is a serious complication in emergency neurosurgical patients, and few data are available on the trends of these infections and the rates of antibacterial drug resistance. Methods: We surveyed retrospectively the patients with intra-cranial bacterial infection in our emergency neurosurgical center between January 2009 and December 2018. Demographic characteristics, causative bacteria, and antimicrobial susceptibility test results were collected. Results: A total of 100 patients with intra-cranial bacterial infection, 1.41% of our patients, were enrolled. There were 123 strains of bacteria cultured from the cerebrospinal fluid (CSF), consisting of 96 strains of gram-negative (GN) bacteria and 27 strains of gram-positive (GP) bacteria. Compared with the GP bacteria, the percentage of GN bacteria increased to 75.0% of the total near the end of the study. Compared with Acinetobacter baumannii, Klebsiella pneumoniae also showed an uptrend. Most of the bacteria were multi-drug-resistant (MDR). We further analyzed the consistency of CSF and sputum cultures from the same patient. The ratio of Klebsiella pneumoniae and Acinetobacter baumannii to the corresponding strains in the CSF were 77.0% and 62.0%. Conclusions: The bacteria recovered from the CSF were mainly GN. The tendency of GN bacteria showed an uptrend, especially for Klebsiella pneumoniae. Furthermore, most of the bacteria were MDR.