Department of Otolaryngology, Head & Neck Surgery, Rigshospitalet, University Hospital of Copenhagen, Denmark.
Epidemiol Infect. 2014 Jun;142(6):1300-9. doi: 10.1017/S0950268813001878. Epub 2013 Aug 9.
This paper estimates the risk of bacterial meningitis following surgery between 1996 and 2009 in Denmark. We conducted two retrospective nationwide cohort studies; first by linking notified bacterial meningitis cases to the National Patient Registry to see how many had undergone a surgical procedure; second, we scrutinized notified bacterial meningitis cases to see if the clinician suspected a surgical procedure to be the aetiology. We found that ear, nose and throat surgery had an 11-fold, and neurosurgery a sevenfold, increased risk compared to the reference group in the first 10 days following surgery. Streptococcus pneumoniae was the pathogen most often involved. Operation procedures involving penetration of dura mater was associated with increased risk for post-operative bacterial meningitis. In absolute numbers we found few bacterial meningitis cases after surgery; however, patients undergoing certain surgical procedures are at-risk and should be considered when national vaccination guidelines are revised.
本文旨在评估 1996 年至 2009 年期间丹麦手术后细菌性脑膜炎的发病风险。我们进行了两项回顾性全国队列研究；首先，通过将报告的细菌性脑膜炎病例与国家患者登记处进行链接，以了解有多少患者接受了手术；其次，我们仔细检查了报告的细菌性脑膜炎病例，以确定临床医生是否怀疑手术是病因。我们发现，与参考组相比，在手术后的前 10 天内，耳鼻喉科手术的风险增加了 11 倍，神经外科手术的风险增加了 7 倍。最常涉及的病原体是肺炎链球菌。涉及硬脑膜穿透的手术操作与术后细菌性脑膜炎的风险增加有关。从绝对数字来看，手术后细菌性脑膜炎的病例很少；然而，某些手术的患者存在风险，在修订国家疫苗接种指南时应考虑这些风险。
