Neurosurgical Infections

Sader, Elie; Moore, Justin M.; Cervantes‐Arslanian, Anna M.

doi:10.1055/s-0039-1693107

Cited by 11 publications

(9 citation statements)

References 68 publications

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“…Over the last couple of decades surgical sciences have moved progressive with advancing methods to reduce the complications associated with surgical site infections (SSI) [ 1 ]. Complications in neurosurgery can be catastrophic with significant associated morbidity and mortality [ [14] , [15] , [16] ].…”

Section: Discussionmentioning

confidence: 99%

“…A qualitative breakdown of the neurosurgical interventions reveals that five shunts were performed in the period under investigation, three of which received antibiotics and two were not. A single case that received a course of antibiotics underwent a revision of Ventriculo-Peritoneal (VP) shunt, although notoriously insertion VP shunts are known for high complications (up to a third within 30-days) associated with blockage and/or infection [ [15] , [16] , [17] , [18] ]. It would perhaps explain the reticence by some professionals not to prescribe antibiotics.…”

Section: Discussionmentioning

confidence: 99%

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Adverse financial and clinical burden of the use of prophylactic antibiotics in neurosurgical patients

Khan¹,

Shamshad²,

Batchelor-Parry³

et al. 2023

Surgery Open Science

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Adverse financial and clinical burden of the use of prophylactic antibiotics in neurosurgical patients

Khan¹,

Shamshad²,

Batchelor-Parry³

et al. 2023

Surgery Open Science

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“…Um estudo de revisão de literatura apontou que pacientes que recebem shunts apresentam infecções em 4 a 17% das vezes. Já a craniotomia a infecção ocorre entre 5 a 8% e cirurgias na coluna espinhal 6% 13 . A taxa de incidência para IRAS em pacientes submetidos a neurocirurgias em Rondônia foi 19,4/100 pacientes (IC95%: 8,19 -36,02), valor superior ao encontrado em um estudo de coorte retrospectivo de três anos, conduzido em um hospital universitário de um país Árabe, com 913 pacientes em tratamento neurológicos onde encontrou uma taxa de incidência geral de IRAS de 11,9/100 pacientes, entre os quais 29% tiveram múltiplas infecções 14 .…”

Section: Discussionunclassified

“…Da mesma forma, os pacientes podem ter um nível de consciência rebaixada o que dificulta a queixa de sintomas e um detalhado exame neurológico. Exames laboratoriais de sangue também podem ser inespecíficos e os exames complementares como a coleta de liquor cefaloraquidiano por si só pode aumentar o risco de introduzir secundariamente infecção 13 .…”

Section: Discussionunclassified

Fatores de risco nas neurocirurgias: um estudo de coorte no norte do Brasil

Araújo

Pereira²,

Deus³

et al. 2022

Rev Cuid

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Introducción: Los pacientes neuroquirúrgicos tienen un alto riesgo de complicaciones locales y sistémicas que pueden aumentar la estancia hospitalaria y el riesgo de muerte. Este estudio tiene como objetivo evaluar la incidencia de infecciones asociadas a la atención médica y los factores de riesgo asociados en pacientes sometidos a neurocirugía. Materiales y Métodos: Estudio de cohorte prospectivo, realizado en un gran hospital del estado de Rondônia, de 2018 a 2019, con 36 pacientes. Resultados: La incidencia de infecciones asociadas a la asistencia sanitaria fue de 19,4 por 100 pacientes (IC95%: 8,19 – 36,02). Haber utilizado una sonda nasoenteral aumentó el riesgo de IRAS en 6,5 veces (IC 95%: 1,26 – 33,5), la ventilación mecánica aumentó el riesgo en 5,52 veces (IC 95%: 1,23 – 24,6), la presencia de traqueotomía aumentó seis veces (IC95%: 1,34 – 26,8) y realizar un examen invasivo aumentó el riesgo de infección en 6,79 (IC95%: 1,31 – 35,05). En el análisis ajustado, las variables no presentaron significación estadística. Discusión: La incidencia de infecciones fue mayor que en las regiones con mejores condiciones socioeconómicas, lo que puede estar relacionado con una menor adherencia a las buenas prácticas de cuidado. Conclusión: En neurocirugía, además de las infecciones del sitio quirúrgico, también se deben considerar otras topografías para la investigación de la infección. El uso de dispositivos invasivos se asoció con la ocurrencia de infecciones relacionadas con el cuidado de la salud, por lo que las buenas prácticas en su uso son fundamentales a la hora de indicar y utilizar estos dispositivos. Como citar este artículo: Araújo, Laís Xavier de; Pereira, Priscilla Perez da Silva; Deus, Josimeire Cantanhêde de; Pontes, Daniela Oliveira; Hang, Adriana Tavares; Freitas, Jeanne Lúcia Gadelha; da Silva, Valéria Moreira; Paiva, Karla de Paula; de Souza, Caren Juliana Moura; Meireles, Carla Vanessa Suaris; Rodrigues, Mariana Delfino; Tavares, Daniella Thamara da Silva; Rosa, Marcela Miranda Sanches. Fatores de risco nas neurocirurgias: um estudo de coorte no norte do Brasil. Revista Cuidarte. 2022;13(2): e2154. http://dx.doi.org/10.15649/cuidarte.2154

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“…3-13.5) and in a recent study, the mean rate was 3.96/1000 catheter-days. [5][6][7] On the other hand, ventriculoperitoneal (VP) and ventriculoatrial shunts to the peritoneal cavity and the right atrium, respectively, provide more permanent CSF diversion alternatives. The VP shunts are used more often, having an infection rate of 11.7% (range 4.1-20.5%).…”

Section: Introductionmentioning

confidence: 99%

Current Perspectives on the Diagnosis and Management of Healthcare-Associated Ventriculitis and Meningitis

Karvouniaris¹,

Brotis²,

Tsiakos³

et al. 2022

IDR

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Ventriculitis or post-neurosurgical meningitis or healthcare-associated ventriculitis and meningitis (VM) is a severe infection that complicates central nervous system operations or is related to the use of neurosurgical devices or drainage catheters. It can further deteriorate patients who have already presented significant neurologic injury and is associated with high morbidity, mortality, and poor functional outcome. VM can be difficult to distinguish from aseptic meningitis, inflammation that follows hemorrhagic strokes and neurosurgical operations. The associated microorganisms can be either skin flora or nosocomial pathogens, most commonly, Gram-negative bacteria. Classical microbiology can fail to isolate the culprit pathogen. Novel cerebrospinal fluid (CSF) biomarkers and molecular microbiology can fill the diagnostic gap and expedite pathogen identification and treatment. The pathogens may demonstrate significant resistant patterns and their antibiotic treatment can be difficult, as many important drug classes, including the beta-lactams and the glycopeptides, hardly penetrate to the CSF, and do not achieve therapeutic levels at the site of the infection. Treatment modifications, such as higher daily dose and prolonged or continuous administration, might increase antibiotic levels in the site of infection and facilitate pathogens clearance. However, in the case of therapeutic failure or infection due to difficultto-treat bacteria, the direct antibiotic instillation into the CSF, in addition to the intravenous antibiotic delivery, may help in the resolution of infection. However, intraventricular antibiotic therapy may result in aseptic meningitis and seizures, concerning the administration of aminoglycosides, polymyxins, and vancomycin. Meanwhile, bacteria form biofilms on the catheter or the device that should routinely be removed. Novel neurosurgical treatment modalities comprise endoscopic evacuation of debris and irrigation of the ventricles. VM prevention includes perioperative antibiotics, antimicrobial impregnated catheters, and the implementation of standardized protocols, regarding catheter insertion and manipulation.

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Neurosurgical Infections

Cited by 11 publications

References 68 publications

Adverse financial and clinical burden of the use of prophylactic antibiotics in neurosurgical patients

Adverse financial and clinical burden of the use of prophylactic antibiotics in neurosurgical patients

Fatores de risco nas neurocirurgias: um estudo de coorte no norte do Brasil

Current Perspectives on the Diagnosis and Management of Healthcare-Associated Ventriculitis and Meningitis

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