Risk factors for meningitis after craniotomy for gliomas: A 8-year experience from a tertiary medical center

Abstract

Abstract Object: Meningitis is a diffuse inflammation that occurs on the meninges. Due to the fact that glioma surgery requires manipulation of the brain parenchyma and the expression of inflammatory mediators, there is often a possibility of meningitis occurring after surgery. Previous studies on meningitis related to neurosurgery have uniformly explored the risk factors for postoperative meningitis in all neurosurgery surgeries that require craniotomy, but have not explored the risk factors and clinical characteristics of postoperative meningitis in a single disease. Methods: We included patients who underwent glioma resection from January 2015 to March 2023, systematically recorded population characteristics, clinical, surgical, laboratory, microbiological, and survival data, analyzed high-risk factors for postoperative meningitis, summarized cerebrospinal fluid characteristics, antibiotic use, and explored whether meningitis affects the long-term prognosis of glioma patients after surgery. Results:All 337 patients underwent glioma resection, and 61 patients (18.1%) developed meningitis after surgery. Among them, 3 patients (0.9%) had positive cerebrospinal fluid pathogen culture, including Staphylococcus haemolyticus, Staphylococcus epidermidis, and Acinetobacter baumanii. Ventricle Opening, post-op other systemic infections, post-op maximum cavity diameter, and peripheral blood Monocyte% are independent risk factors for postoperative meningitis. The median protein content in cerebrospinal fluid of patients with meningitis is 1.73g/L ([IQR] 1.03-3.06), the median glucose content is 2.7mmol/L ([IQR] 1.90-3.70), and the median WBC is 1478×106cells/L ([IQR] 455-4198×106), with a median percentage of multinucleated cells of 83.7% ([IQR] 69.30% -90.80%). Meropenem and Vancomycin are the most commonly used antibiotics, with an average usage time of 7.79 days and 8.41 days, respectively. Survival analysis suggests that the occurrence of meningitis does not affect the long-term prognosis of glioma patients after surgery. Conclusions: This study separately explored the risk factors for meningitis in patients with glioma after surgery, instead of all diseases which need craniotomy，and summarized their cerebrospinal fluid characteristics and antibiotic use. Although meningitis is only one of the possible complications during the treatment of gliomas, we believe that this will make a certain contribution to neurosurgeons' individualized prevention, diagnosis, and treatment of patients in the diagnosis and treatment of gliomas.