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Factors affecting in-hospital mortality and outcome study on healthcare-associated meningitis and/or ventriculitis (HCAMV): University of Malaya Medical Centre experience

Background & Objectives: Healthcare-associated Meningitis and/or Ventriculitis (HCAMV) is a serious yet frequent complication following neurosurgery. In this study, the clinical outcomes of HCAMV, risk factors associated with the clinical outcome, etiological agents and their corresponding antib...

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Main Authors: Lee, Yu Jie, Atiya, Nadia, Yeat, Nai Shan, Sidhu, Amritpal, Sulaiman, Helmi
Format: Article
Published: ASEAN Neurological Association 2021
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RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Online Access:http://eprints.um.edu.my/27932/
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spelling my.um.eprints.279322022-04-18T06:27:33Z http://eprints.um.edu.my/27932/ Factors affecting in-hospital mortality and outcome study on healthcare-associated meningitis and/or ventriculitis (HCAMV): University of Malaya Medical Centre experience Lee, Yu Jie Atiya, Nadia Yeat, Nai Shan Sidhu, Amritpal Sulaiman, Helmi RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry Background & Objectives: Healthcare-associated Meningitis and/or Ventriculitis (HCAMV) is a serious yet frequent complication following neurosurgery. In this study, the clinical outcomes of HCAMV, risk factors associated with the clinical outcome, etiological agents and their corresponding antibiogram were investigated. Methods: All HCAMV patients treated in University Malaya Medical Centre (UMMC) from 2012-2017 were retrospectively reviewed. The inclusion criteria were 1) adult patient of 18 years of age and above, 2) positive CSF culture and 3) diagnosed as HCAMV after neurosurgical procedure. Patients' clinical data, etiological agents and the antibiogram of HCAMV were recorded. Patients were interviewed via phone to assess neurological deficit post-discharge. Clinical outcomes were Glasgow Coma Scale (GCS) during onset of HCAMV, patient's mortality, and post-discharge modified Rankin Scale (mRS). Results: Fifty two subjects were included in our study and male subjects predominated (65.4%, n=34) with the median age of 53 years old (range 20-75). Close to half of them had severe GCS (46.2%, n=24) and were intubated (48.1%, n=25). In regard to organisms recovered from the CSF, Gram-negative bacteria predominated (59.6%, n=31). Of these Acinetobacter baumannii was the commonest (38.5%, n=20) and carbapenem resistance was documented in 75% (n=15) of Acinetobacter baumannii. In-hospital mortality rate was 32.7% (n=17) and additional 20 subjects died within a year of HCAMV diagnosis. Multivariate analysis showed intubation associated with in-hospital mortality in this study (aOR, 0.3; P = 0.001). Conclusion: We reported a high percentage of HCAMV caused by carbapenem-resistant Acinetobacter baumannii and intubation is an independent risk factor for in-hospital mortality. ASEAN Neurological Association 2021-06 Article PeerReviewed Lee, Yu Jie and Atiya, Nadia and Yeat, Nai Shan and Sidhu, Amritpal and Sulaiman, Helmi (2021) Factors affecting in-hospital mortality and outcome study on healthcare-associated meningitis and/or ventriculitis (HCAMV): University of Malaya Medical Centre experience. Neurology Asia, 26 (2). pp. 265-272. ISSN 1823-6138,
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
spellingShingle RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Lee, Yu Jie
Atiya, Nadia
Yeat, Nai Shan
Sidhu, Amritpal
Sulaiman, Helmi
Factors affecting in-hospital mortality and outcome study on healthcare-associated meningitis and/or ventriculitis (HCAMV): University of Malaya Medical Centre experience
description Background & Objectives: Healthcare-associated Meningitis and/or Ventriculitis (HCAMV) is a serious yet frequent complication following neurosurgery. In this study, the clinical outcomes of HCAMV, risk factors associated with the clinical outcome, etiological agents and their corresponding antibiogram were investigated. Methods: All HCAMV patients treated in University Malaya Medical Centre (UMMC) from 2012-2017 were retrospectively reviewed. The inclusion criteria were 1) adult patient of 18 years of age and above, 2) positive CSF culture and 3) diagnosed as HCAMV after neurosurgical procedure. Patients' clinical data, etiological agents and the antibiogram of HCAMV were recorded. Patients were interviewed via phone to assess neurological deficit post-discharge. Clinical outcomes were Glasgow Coma Scale (GCS) during onset of HCAMV, patient's mortality, and post-discharge modified Rankin Scale (mRS). Results: Fifty two subjects were included in our study and male subjects predominated (65.4%, n=34) with the median age of 53 years old (range 20-75). Close to half of them had severe GCS (46.2%, n=24) and were intubated (48.1%, n=25). In regard to organisms recovered from the CSF, Gram-negative bacteria predominated (59.6%, n=31). Of these Acinetobacter baumannii was the commonest (38.5%, n=20) and carbapenem resistance was documented in 75% (n=15) of Acinetobacter baumannii. In-hospital mortality rate was 32.7% (n=17) and additional 20 subjects died within a year of HCAMV diagnosis. Multivariate analysis showed intubation associated with in-hospital mortality in this study (aOR, 0.3; P = 0.001). Conclusion: We reported a high percentage of HCAMV caused by carbapenem-resistant Acinetobacter baumannii and intubation is an independent risk factor for in-hospital mortality.
format Article
author Lee, Yu Jie
Atiya, Nadia
Yeat, Nai Shan
Sidhu, Amritpal
Sulaiman, Helmi
author_facet Lee, Yu Jie
Atiya, Nadia
Yeat, Nai Shan
Sidhu, Amritpal
Sulaiman, Helmi
author_sort Lee, Yu Jie
title Factors affecting in-hospital mortality and outcome study on healthcare-associated meningitis and/or ventriculitis (HCAMV): University of Malaya Medical Centre experience
title_short Factors affecting in-hospital mortality and outcome study on healthcare-associated meningitis and/or ventriculitis (HCAMV): University of Malaya Medical Centre experience
title_full Factors affecting in-hospital mortality and outcome study on healthcare-associated meningitis and/or ventriculitis (HCAMV): University of Malaya Medical Centre experience
title_fullStr Factors affecting in-hospital mortality and outcome study on healthcare-associated meningitis and/or ventriculitis (HCAMV): University of Malaya Medical Centre experience
title_full_unstemmed Factors affecting in-hospital mortality and outcome study on healthcare-associated meningitis and/or ventriculitis (HCAMV): University of Malaya Medical Centre experience
title_sort factors affecting in-hospital mortality and outcome study on healthcare-associated meningitis and/or ventriculitis (hcamv): university of malaya medical centre experience
publisher ASEAN Neurological Association
publishDate 2021
url http://eprints.um.edu.my/27932/
_version_ 1735409539546611712
score 13.211869

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