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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Propionibacterium acnes infections after cranial neurosurgery.
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Propionibacterium acnes infections after cranial neurosurgery.

机译：颅神经外科手术后痤疮丙酸杆菌感染。

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摘要

BACKGROUND: Propionibacterium acnes (P. acnes) is a relatively avirulent organism that is part of the normal skin flora. Most patient isolates are considered contaminants but, in a small subset of patients, particularly in the post-neurosurgery setting, the organism can cause significant infections. We reviewed our experience with the occurrence and management of P. acnes infections after cranial neurosurgical procedures over a five-year period. METHODS: Patients with positive cultures for P. acnes between 1996 and 2001 were identified by review of the Saskatoon Health Region microbiology laboratory database. Of the 141 positive cultures, a review of hospital records identified six patients with P. acnes infections after neurosurgical procedures. A review of the literature related to P. acnes associated CNS infections was conducted. RESULTS: All patients had undergone a craniotomy or burrhole placement, and one patient had received prior radiotherapy. There were no P. acnes-related ventriculoperitonealshunt infections. All patients presented with scalp swelling and three had purulent discharge. Symptoms occurred more than two months after the initial surgery in five of six patients, while one patient developed symptoms three years post-operatively. Management for all patients included removal of the craniotomy flap and treatment with parenteral antibiotics, followed in most cases by oral antibiotics. A good response without relapse of infection was seen in five patients; one patient had recurrent infection after cranioplasty. CONCLUSIONS: P. acnes is a rare but important cause of infection after craniotomy. Wound debridement, removal of the bone flap and adequate antibiotic coverage result in cure in the majority of patients.
机译：背景：痤疮丙酸杆菌（痤疮丙酸杆菌）是一种相对无毒的生物，是正常皮肤菌群的一部分。大多数患者分离株被认为是污染物，但是在一小部分患者中，尤其是在神经外科手术后的环境中，该生物体会引起严重感染。我们回顾了五年后颅神经外科手术后痤疮丙酸杆菌感染的发生和处理的经验。方法：通过回顾萨斯卡通健康区微生物实验室数据库，鉴定1996年至2001年痤疮丙酸杆菌培养阳性的患者。在141种阳性培养物中，对医院记录的回顾确定了6例神经外科手术后痤疮丙酸杆菌感染的患者。进行了与痤疮丙酸杆菌相关的中枢神经系统感染有关的文献综述。结果：所有患者均接受了颅骨切开术或孔洞置入术，其中一名患者接受了放疗。没有痤疮丙酸杆菌相关的心室腹膜旁路感染。所有患者均出现头皮肿胀，其中三例有脓性分泌物。六名患者中有五名在首次手术后两个多月出现症状，而一名患者在术后三年后出现症状。所有患者的治疗都包括开颅手术皮瓣和肠胃外抗生素治疗，大多数情况下口服抗生素治疗。五例患者反应良好，无感染复发。一名患者在颅骨成形术后再次感染。结论：痤疮丙酸杆菌是开颅术后罕见但重要的感染原因。伤口清创术，去除骨瓣和足够的抗生素覆盖率可治愈大多数患者。

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