OBJECTIVE To explore the clinical significance of antimicrobial susceptibility analysis and combined detection of microRNA (miR)-92b, miR-21, (C-X-C motif) ligand (CXCL) 10 and procalcitonin (PCT) for intracranial infections after neurosurgery.

METHODS Ninety-seven patients with intracranial infections after neurosurgery who received treatment at Panzhihua Central Hospital from Oct. 2019 to Dec. 2023 were selected as the infection group, and 106 patients without intracranial infections admitted during the same period as the no infection group. The clinical data and levels of miR-92b, miR-21, CXCL10 and PCT of the two groups were compared; the distribution and drug sensitivity of pathogenic bacteria in postoperative intracranial infections were analyzed; the diagnostic values of combined detection of miR-92b, miR-21, CXCL10 and PCT were evaluated by receiver operating characteristic (ROC) curve analysis.

RESULTS The patients with history of diabetes, cerebrospinal fluid leakage, extra-ventricular drainage and hypoproteinemia in the infected group accounted for 29.90%, 75.26%, 52.58% and 23.71%, respectively, which were higher than those in the uninfected group; the length of surgical and postoperative indwelling of drainage tubes in the infected group were (4.87±0.23) h and (28.54±1.03) h, respectively, both longer than those in the non-infected group; the preoperative glasgow coma scale (GCS) of the infection group was (6.03±0.36), which was lower than that of the no infection group (P < 0.05). A total of 103 strains of pathogenic bacteria were isolated from 97 infected patients, of which gram-positive bacteria accounting for 41.75% and negative bacteria 57.28%. The most common pathogens were Acinetobacter baumannii (24.27%) and fungi (0.97%); A. baumannii had low resistance to sulfamethoxazole/trimethoprim, ciprofloxacin, and polymyxin, with resistance rates of 44.00%, 40.00% and 0, respectively. Compared with the uninfected group, the levels of miR-92b, miR-21, CXCL10, and PCT in the cerebrospinal fluid of the infected group were higher (P < 0.05). The area under the curves (AUC) of miR-92b, miR-21, CXCL10, PCT and their combined detection for diagnosing intracranial infections after neurosurgery were 0.718, 0.743, 0.664, 0.781, and 0.913, respectively; the highest AUC was observed in the combined detection (P < 0.05).

CONCLUSIONS The combined detection of miR-92b, miR-21, CXCL10 and PCT in cerebrospinal fluid is beneficial for diagnosing intracranial infections after neurological surgery with raised diagnostic values. The dominant pathogenic bacteria of intracranial infections is A. baumannii, which can promote clinical diagnosis and anti-infective treatment and further improve the patients′ prognosis.