Journal article
Infection Rate after Cranial Neurosurgical Procedures: A Prospective Single-Center Study.
- Strahm C Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland. Electronic address: carol.strahm@kssg.ch.
- Albrich WC Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
- Zdravkovic V Department of Orthopedic Surgery and Traumatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
- Schöbi B Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
- Hildebrandt G Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
- Schlegel M Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
- 2017-12-23
Published in:
- World neurosurgery. - 2018
Cranial neurosurgery
EVD
Extraventricular drainage
Prospective SSI surveillance
Surgical site infection
Adolescent
Adult
Aged
Aged, 80 and over
Cohort Studies
Female
Humans
Incidence
Male
Middle Aged
Neurosurgical Procedures
Prospective Studies
Skull
Surgical Wound Infection
Young Adult
English
OBJECTIVE
To determine infection rate (IR) and to identify modifiable risk factors (RF) in cranial neurosurgery in a neurosurgical department for tertiary referral as part of an infection control surveillance to reduce surgical site infections (SSI).
METHODS
A prospective SSI incidence cohort study from February 2013 to January 2014 was performed in a tertiary-care neurosurgical teaching hospital and referral center. All consecutive adults undergoing any cranial neurosurgical procedure were included. Data were collected by a trained member of the infection control staff during the twice-weekly visits of the hospitalized patients. Follow-up was 30 days (procedures without implant) and 1 year (procedures involving permanent implants). SSI was diagnosed according to criteria of CDC.
RESULTS
A total of 317 patients undergoing 333 index procedures were included. The median age was 61 years (range, 17-91 years) and 46% were female. Survival in patients with completed follow-up was 76% (196/258). Overall, IR was 7.2% (24/333 index procedures); in 96% (23/24), a neurosurgical implant was involved. The IR of extraventricular drainage (EVD) was 12.5% (13.1/1000 EVD days). The main causative pathogens were Staphylococcus aureus followed by coagulase-negative staphylococci and Propionibacterium acnes. Independent RF for neurosurgical SSI were EVD as part of the index operation and body mass index >25 kg/m2.
CONCLUSIONS
IR was in accordance with recent prospective single-center studies (reported IR between 1.6% and 9%). EVD placement was identified as the strongest modifiable RF for SSI in cranial neurosurgical procedures. The need for standard infection control procedures for the insertion and maintenance of EVDs to avoid their contamination is reinforced.
To determine infection rate (IR) and to identify modifiable risk factors (RF) in cranial neurosurgery in a neurosurgical department for tertiary referral as part of an infection control surveillance to reduce surgical site infections (SSI).
METHODS
A prospective SSI incidence cohort study from February 2013 to January 2014 was performed in a tertiary-care neurosurgical teaching hospital and referral center. All consecutive adults undergoing any cranial neurosurgical procedure were included. Data were collected by a trained member of the infection control staff during the twice-weekly visits of the hospitalized patients. Follow-up was 30 days (procedures without implant) and 1 year (procedures involving permanent implants). SSI was diagnosed according to criteria of CDC.
RESULTS
A total of 317 patients undergoing 333 index procedures were included. The median age was 61 years (range, 17-91 years) and 46% were female. Survival in patients with completed follow-up was 76% (196/258). Overall, IR was 7.2% (24/333 index procedures); in 96% (23/24), a neurosurgical implant was involved. The IR of extraventricular drainage (EVD) was 12.5% (13.1/1000 EVD days). The main causative pathogens were Staphylococcus aureus followed by coagulase-negative staphylococci and Propionibacterium acnes. Independent RF for neurosurgical SSI were EVD as part of the index operation and body mass index >25 kg/m2.
CONCLUSIONS
IR was in accordance with recent prospective single-center studies (reported IR between 1.6% and 9%). EVD placement was identified as the strongest modifiable RF for SSI in cranial neurosurgical procedures. The need for standard infection control procedures for the insertion and maintenance of EVDs to avoid their contamination is reinforced.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.wneu.2017.12.062
- PMID 29269070
- Persistent URL
- https://sonar.ch/global/documents/186480
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