Risk factors for surgical site infections in neurosurgery patients with antibiotic prophylaxis

Erman, Tahsin; Demırhındı, Hakan; Göçer, A. İskender; Tuna, Metin; İldan, Faruk; Boyar, Bülent

doi:10.1016/j.surneu.2004.04.024

Cited by 107 publications

(86 citation statements)

References 41 publications

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“…When prophylactic antibiotics are used the infection rates in clean neurosurgical operations in randomized controlled trials is 0.3 % to 3 % and 4 % to 12 % without prophylactic antibiotics. Recently, infectious complications less than 5 % is considered acceptable (14). Surgical site infections rate of 12.8 % in our study was higher than the acceptable range.…”

Section: Discussioncontrasting

confidence: 57%

Risk Factors of Nosocomial Infections in a Neurosurgery Clinic

Borcak¹,

Çelik²,

Durmuş³

2017

Turk J Bioch

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ÖzetGİRİŞ ve AMAÇ: Hastane enfeksiyonları hastanın hastaneye başvurusu esnasında bulunmayan veya inkübasyon döneminde olmayan, hastaneye başvurduktan 48-72 saat sonra veya hastaneden taburcu olduktan sonraki 10 gün içinde gelişen enfeksiyonlardır. Standardizasyonu sağlamak, Türkiye ve gelişmiş ülkelerin hastaneleri ile karşılaştırma yapabilmek için Beyin Cerrahisi Kliniği'ndeki hastane enfeksiyonu oranlarını, enfeksiyon etkeni mikroorganizmaları ve direnç kalıplarını belirlemek amaçlanmıştır. YÖNTEM ve GEREÇLER: Bu çalışmada beyin cerrahisi hastalarında hastane enfeksiyonu gelişimindeki risk faktörleri hasta kayıtları gözden geçirilerek ve hasta bilgileri ile mikrobiyoloji kültür sonuçları kaydedilerek analiz edilmiştir. BULGULAR: Çalışmada 57 hastada 78 hastane enfeksiyonu atağı belirlendi ve hastane enfeksiyonu hızı % 10,34 olarak tespit edildi. Hastane enfeksiyon ataklarının % 53,8'i pnömoni, % 15.4'ü üriner sistem enfeksiyonu, % 12,8'i cerrahi alan enfeksiyonu, % 11.5'i merkezi sinir sistemi enfeksiyonu, % 6.4'ü kateter ilişkili kan dolaşım enfeksiyonuydu. Hastane enfeksiyonlarından en sık izole edilen etkenler Acinetobacter baumanii (% 16,4), Pseudomonas aeruginosa (% 16,4) ve Metisilin duyarlı Staphylococcus aureus (%16,4) idi. Yaşın 65 üzerinde olması, sigara kullanımı, fekal inkontinans, malignite, birden fazla cerrahi girişim varlığının hastane enfeksiyonu gelişiminde risk faktörü olduğu saptanmıştır. TARTIŞMA ve SONUÇ: Hastane enfeksiyonu gelişiminde rol oynayan risk faktörlerinin tanımlanması, etken mikroorganizmaların belirlenmesi enfeksiyon kontrol ve önleme programlarını geliştirilmesi, beyin cerrahisi hastasının değerlendirilmesi, tanı ve tedavisine yaklaşımda önemlidir. Abstract INTRODUCTION:Nosocomial infections are acquired during hospital care which were not present or incubating at the time of the patient's admission to the hospital. They occur more than 48 to 72 hours after admission and up to 10 days after hospital discharge. The aim of the present study was to determine Neurosurgery Clinic's nosocomial infection rates, infecting microorganisms, and their resistance patterns to achieve standardization and make comparisons among other Turkish and developed country hospitals. METHODS: In this study risk factors for nosocomial infection development in neurosurgery patients were analyzed by reviewing patient cards retrospectively, and recording microbiological culture results. RESULTS: Seventy eight nosocomial infection attacks were defined in 57 patients and the incidence of nosocomial infection attacks were 10.34%. Of the nosocomial infection attacks 53.8 % was pneumonia, 15.4 % was urinary tract infection, 12.8 % was surgical site infection, 11.5 % was central nervous system infection and 6.4 % was catheter related blood stream infection. Acinetobacter baumanii, Pseudomonas aeruginosa and Methicillin sensitive Staphylococcus aureus remained the most common pathogens isolated from nosocomial infections. Factors significantly associated with hospital acquired infection were as follows: age (>6...

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Section: Discussioncontrasting

confidence: 57%

Risk Factors of Nosocomial Infections in a Neurosurgery Clinic

Borcak¹,

Çelik²,

Durmuş³

2017

Turk J Bioch

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“…In the study by Erman et al, 5 perioperative steroid use did not remain an independent risk factor for the development of SSIs in the multivariate analysis. In the prospective study by Reichert et al 28 and the retrospective study by Kourbeti et al 15 on the risk factors associated with PCM, steroid administration did not reach a statistical significance.…”

Section: 23mentioning

confidence: 76%

“…The increase in the rate of Acinetobacter PCM has been extensively described in the years following 2000, although in the previous years it was reported as a rare occurrence. 4,5,18,22,28,32,36 The main issue with the Acinetobacter spp. is their increasing resistance to almost all antibiotic classes (including carbapenems), which has been a significant problem in the recent years.…”

Section: Meningitismentioning

confidence: 99%

“…This has not been described before in studies regarding PCM and in most studies regarding postoperative wound infections in general neurosurgical patients. 4,5,[12][13][14][15]23,26,28,33 The effect of steroids on patients undergoing neurosurgical procedures has been variably reported. 21 In certain studies, the steroid effect has not been specifically investigated.…”

Section: 23mentioning

confidence: 99%

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Infections in patients undergoing craniotomy: risk factors associated with post-craniotomy meningitis

Kourbeti¹,

Vakis²,

Ziakas

et al. 2015

JNS

141

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OBJECT The authors performed a prospective study to define the prevalence and microbiological characteristics of infections in patients undergoing craniotomy and to clarify the risk factors for post-craniotomy meningitis. METHODS Patients older than 18 years who underwent nonstereotactic craniotomies between January 2006 and December 2008 were included. Demographic, clinical, laboratory, and microbiological data were systemically recorded. Patient characteristics, craniotomy type, and pre- and postoperative variables were evaluated as risk factors for meningitis RESULTS Three hundred thirty-four procedures were analyzed (65.6% involving male patients). Traumatic brain injury was the most common reason for craniotomy. Almost 40% of the patients developed at least 1 infection. Ventilatorassociated pneumonia (VAP) was the most common infection recorded (22.5%) and Acinetobacter spp. were isolated in 44% of the cases. Meningitis was encountered in 16 procedures (4.8%), and CSF cultures were positive for microbial growth in 100% of these cases. Gram-negative pathogens (Acinetobacter spp., Klebsiella spp., Pseudomonas aeruginosa, Enterobacter cloaceae, Proteus mirabilis) represented 88% of the pathogens. Acinetobacter and Klebsiella spp. demonstrated a high percentage of resistance in several antibiotic classes. In multivariate analysis, the risk for meningitis was independently associated with perioperative steroid use (OR 11.55, p = 0.005), CSF leak (OR 48.03, p < 0.001), and ventricular drainage (OR 70.52, p < 0.001). CONCLUSIONS Device-related postoperative communication between the CSF and the environment, CSF leak, and perioperative steroid use were defined as risk factors for meningitis in this study. Ventilator-associated pneumonia was the most common infection overall. The offending pathogens presented a high level of resistance to several antibiotics.

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“…The SSI incidence in our Hospital has dropped dramatically over the years, from 8.8% in 1994 to 3.3% in 2003. Other authors have reported incidences of 1.2% [18], 4.4% [19], 5.7% [20], 6.2% [21], and up to 12% [22].…”

Section: Discussionmentioning

confidence: 99%

Surgical site infection in a university hospital in northeast Brazil

Medeiros¹,

Aires-Neto²,

Azevedo³

et al. 2005

Braz J Infect Dis

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We examined prevention of surgical site infection (SSI) in a tertiary teaching hospital in northeast Brazil, from January 1994 to December 2003. The survey included 5,742 patients subjected to thoracic, urologic, vascular and general surgery. The criteria for diagnosing SSI were those of the Centers for Disease Control, USA, and the variables of the National Nosocomial Infection Surveillance risk index were used. Data analysis revealed that anesthetic risk scores, wound class and duration of surgery were significantly associated with SSI. A total of 296 SSIs were detected among the 5,742 patients (5.1%). The overall incidence of SSI was 8.8% in 1994; it decreased to 3.3% in 2003. In conclusion, the use of educational strategies, based on guidelines for SSI prevention reduced SSI incidence. Appropriate management of preoperative, intraoperative, and postoperative incision care, and a surveillance system based on international criteria, were useful in reducing SSI rates in our hospital.

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Risk factors for surgical site infections in neurosurgery patients with antibiotic prophylaxis

Cited by 107 publications

References 41 publications

Risk Factors of Nosocomial Infections in a Neurosurgery Clinic

Risk Factors of Nosocomial Infections in a Neurosurgery Clinic

Infections in patients undergoing craniotomy: risk factors associated with post-craniotomy meningitis

Surgical site infection in a university hospital in northeast Brazil

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