Department of Clinical Diagnosis, Laboratory of Beijing Tiantan Hospital and Capital Medical University, NO. 119 Nansihuan West road, Fengtai district, Beijing, China.
Daqing Oilfield General Hospital Clinical Laboratory, No. 9 Zhongkang Street, Saltu District, Daqing, China.
BMC Infect Dis. 2021 Jan 19;21(1):85. doi: 10.1186/s12879-021-05784-7.
To determine the phenotype, molecular characterisation and risk factors of postoperative meningitis induced by Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (EPE) in China.
We performed a multi-centre comparative cohort study of postoperative meningitis patients infected with Enterobacteriaceae in 4 neurosurgical centres in China from January 2014 to December 2019. Phenotype and molecular characteristics of the isolates were reviewed and tested, and independent risk factors of the EPE meningitis were evaluated by binary logistic regression.
In total, 220 Enterobacteriaceae include 78 EPE were available in this study. 85.6% (67/78) ESBL-related genes were tested, and bla (14.9%) and bla + bla + bla (20.9%) were found to be the most frequent mono and combined ESBL-related genes harboured by Enterobacteriaceae. On binary logistic analysis, craniotomy (OR. 2.583, 95% C.I. 1.274-5.235, P = 0.008) and malignancy (OR. 2.406, 95% C.I. 1.299-4.456, P = 0.005) were the associated independent risk factors to meningitis induced by EPE.
To the best of our knowledge, this is the largest series focusing on risk factors of EPE meningitis which has been conducted in China. Craniotomy and malignancy were independent risk factors for EPE meningitis. The risk factors identified may be further utilized in clinical practice and research to avoid and reduce the mortality in future.
为了确定中国产超广谱β-内酰胺酶（ESBL）肠杆菌科（EPE）引起的术后脑膜炎的表型、分子特征和危险因素。
我们在中国的 4 家神经外科中心进行了一项多中心比较队列研究，纳入了 2014 年 1 月至 2019 年 12 月期间术后感染肠杆菌科的脑膜炎患者。回顾和测试了分离株的表型和分子特征，并通过二项逻辑回归评估了 EPE 脑膜炎的独立危险因素。
本研究共纳入 220 株肠杆菌科，其中 78 株为 EPE。检测到 85.6%（67/78）的 ESBL 相关基因，肠杆菌科最常见的单和组合 ESBL 相关基因分别为 bla（14.9%）和 bla + bla + bla（20.9%）。二元逻辑分析显示，开颅手术（OR. 2.583，95%CI 1.274-5.235，P = 0.008）和恶性肿瘤（OR. 2.406，95%CI 1.299-4.456，P = 0.005）是 EPE 脑膜炎的独立危险因素。
据我们所知，这是在中国进行的关于 EPE 脑膜炎危险因素的最大系列研究。开颅手术和恶性肿瘤是 EPE 脑膜炎的独立危险因素。确定的危险因素可能进一步用于临床实践和研究，以避免和降低未来的死亡率。
