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J Neurol Surg A Cent Eur Neurosurg 2017; 78(05): 467-471
DOI: 10.1055/s-0037-1598658
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Infection Rate in 1033 Elective Neurosurgical Procedures at a University Hospital in South China

Hongwei Zhu
1   Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, Xiamen, China
,
Xiyao Liu
1   Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, Xiamen, China
,
Zhanxiang Wang
1   Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, Xiamen, China
› Institutsangaben
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Publikationsverlauf

06. August 2016

20. Dezember 2016

Publikationsdatum:
24. April 2017 (online)

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Abstract

Objective Infection following surgery is a serious complication, especially in neurosurgery. The aim of the study is to report the change of incidence rates of infection in patients undergoing elective neurosurgical procedures at a university hospital in South China as well as the risk factors.

Material and Methods The medical records and postoperative courses for patients undergoing 1,033 neurosurgical procedures from 2008 to 2014 were reviewed retrospectively to determine the incidence of neurosurgical infection, the identity of the offending organisms, and the factors associated with infection.

Results A total of 33 patients (40 cases) experienced postoperative infection representing 3.19% of the study population. Twenty cases were incision infections (1.94%), and 20 were cranial/spinal infections (1.94%) including 15 intracranial infections and 5 intraspinal infections. The 2.4-fold greater incidence of postoperative infection in 2008 to 2010 was compared with that in 2011 to 2014 with perioperative antibiotic prophylaxis (p <0.01). The neurosurgical procedure associated with the highest rate of infection was cranioplasty (6.85%); the lowest rate of infection was associated with functional neurosurgery (1.08%). The most common offending organism was Staphylococcus aureus (27.5%). Foreign body implantation, operative time > 4 hours, and cerebrospinal fluid (CSF) leak (13 infections in 158 patients; p <0.001) were risk factors for infections (p <0.05).

Conclusion The neurosurgical infection rate is usually low with perioperative antibiotic prophylaxis even in developing countries. Less foreign body implantation, shorter operative times, and controlling CSF leak could reduce infection rates.

Keywords

elective neurosurgery - infection - antibiotic prophylaxis - risk factors