Characteristics of pathogenic bacteria in postoperative intracranial infection after spontaneous intracerebral hemorrhage and correlation with cerebrospinal fluid indicators
HU Yunhua
LI Shuyan
JIANG Fei
DING Lianshu
LI Qianhui
JI Fengqing
CHEN Linfang
Abstract：Objective To investigate the characteristics of pathogenic bacteria causing postoperative intracranial in-fection(ICI)in patients with spontaneous intracerebral hemorrhage(SICH)and their correlation with cerebrospinal fluid(CSF)indicators,providing a reference for clinical anti-infective treatment.Methods The clinical data of 81 SICH patients with postoperative ICI admitted between January 2018 and December 2022 were retrospectively analyzed.The etiological character-istics of CSF culture-positive bacteria were analyzed,and differences in CSF indicators were compared between patients with Gram-negative bacilli(GNB)and Gram-positive cocci(GPC)infections.Results Among the 81 ICI cases,pathogens were de-tected in the CSF of 49 patients,of whom,15(30.60%)were GPC and 34(69.40%)were GNB.There were no statistically sig-nificant differences in age,gender,hemorrhage volume,or admission GCS score between patients with GNB and GPC infections(P>0.05).Compared to patients with GPC infection,those with GNB infection had significantly increased CSF white blood cell(WBC)count,protein level,and lactate dehydrogenase(LDH)level(P<0.05),while the CSF glucose level was significantly de-creased(P<0.05).ROC curve analysis showed that CSF WBC count,protein level,LDH level,and glucose level had certain pre-dictive value for postoperative GNB ICI in SICH patients,with areas under the curve of 0.912,0.831,0.920,and 0.794,respec-tively(P<0.05).Conclusion In our hospital,GNB are the predominant pathogens causing secondary ICI after SICH surgery,exhibiting high drug resistance rates.This suggests that clinicians need to highly prioritize submitting samples for culture before antibiotic administration,reduce the use of broad-spectrum antimicrobials,and decrease iatrogenic drug resistance.Furthermore,for patients suspected of ICI,when etiological evidence is unavailable,CSF WBC count,protein level,LDH level,and glucose content can serve as references for differentiating between GNB and GPC infections.
Keywords：spontaneous intracerebral hemorrhagepostoperative intracranial infectionpathogenic bacteria character-isticscerebrospinal fluid indicatorscorrelation
Publication Date：2025-09-25
Online Publishing Date：2025-11-28(First online date of this platform, not the publication date of the document)
Pages：6( 527-532 )