Incidence of surgical site infection after craniotomy: comparison between three months and twelve months of epidemiological surveillance

Torres, Silvana; Perdiz, Luciana Baria; Medeiros, Eduardo Alexandrino

doi:10.1016/j.bjid.2018.08.001

Cited by 9 publications

(8 citation statements)

References 10 publications

(12 reference statements)

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“…Perioperative surgery duration is one of the important predictors of SSI development and longer the duration of surgery leads to higher risk, evidenced by the OR of 4.7 to 11 [26]. Similarly, the incidence of emergency surgical procedures has higher risks than elective surgical procedures [28,33].…”

Section: Resultsmentioning

confidence: 99%

Epidemiology and Risk Factors of Post Operative Site Infections in Surgical Patients: A Systematic Review

Salahuddin¹,

Muddebihal²,

Thirunavukkarasu³

et al. 2022

Arch. Pharm. Pract

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Surgical site infection (SSI) is one of the most common and serious hospital-acquired infections all over the world. The SSI can lead to an increase in morbidity, mortality, and increase in the duration of hospital stay among patients. The present systematic review was planned to find the epidemiological features, prevalence, causative organisms, and predisposing risk factors for the development of postoperative infections among surgical patients of all the six WHO regions. Initially, 281 articles were identified through specified databases. Finally, 18 articles that fulfilled all inclusions and exclusion criteria are included. For the risk factors assessment, p-values, odds ratio were considered. In general, the occurrence rate of SSI ranges from 2% to 17.8%. Regarding causative organisms, three microorganisms are commonly reported in most of the studies were Staphylococcus aureus, Klebsiella pneumonia, and E.Coli. Among the different procedures reviewed, incidence and prevalence rates were higher among emergency surgical procedures and lower among obstetrics and gynecology procedures. Longer preoperative duration of stays in hospital decreased Hb and serum albumin level, comorbid conditions such as diabetes, hypertension are potential risk factors for the development of SSI. The occurrence rate of SSI among post-operative patients is very high, especially in developing countries. This leads to a double burden on the healthcare delivery settings during the COVID-19 pandemic. It is essential to include a strict infection control policy, fair usage of antibiotics practices to be implemented. It is also recommended to control comorbid conditions before planning for elective surgery.

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Section: Resultsmentioning

confidence: 99%

Epidemiology and Risk Factors of Post Operative Site Infections in Surgical Patients: A Systematic Review

Salahuddin¹,

Muddebihal²,

Thirunavukkarasu³

et al. 2022

Arch. Pharm. Pract

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“…Some of these refined procedures involve breaching the blood–brain barrier or other protective peripheral tissues, which subsequently increases the risk of pathogenic intrusion. In situations where emergency measures are not appropriately managed, the likelihood of SSIs post‐operation becomes imminent, subsequently diminishing the overall prognosis 15 …”

Section: Discussionmentioning

confidence: 99%

“…In situations where emergency measures are not appropriately managed, the likelihood of SSIs post-operation becomes imminent, subsequently diminishing the overall prognosis. 15 In evaluating the microbiological landscape of surgical sites, it is evident that Gram-positive bacteria are the main culprits behind SSIs due to bacterial invasions, emphasising the need for enhanced preventive measures during surgeries. This is further complicated by the rising resistance trends observed in both Gram-positive and Gram-negative bacteria against prevalent antibiotics, warranting culture and sensitivity testing to ascertain the most effective therapeutic agents.…”

Section: Discussionmentioning

confidence: 99%

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Comprehensive analysis of risk factors and pathogenetic characteristics associated with surgical site infections following craniotomy procedures

Gu,

Tu,

Song

et al. 2023

International Wound Journal

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Craniotomies are intricate neurosurgical procedures susceptible to post‐operative complications, among which surgical site infections (SSIs) are particularly concerning. This study sought to elucidate the potential risk factors and pathogenetic characteristics associated with SSIs following craniotomy procedures in a clinical setting. A retrospective study was conducted from May 2020 to May 2023, examining patients subjected to elective or emergency craniotomies. The cohort underwent post‐operative surveillance for SSIs, facilitating patient classification into SSI and Non‐SSI groups based on infection occurrence. Data collection encapsulated demographic and clinical parameters, including American Society of Anesthesiologists (ASA) classifications, and operative factors. SSIs were diagnosed via an integrated approach combining clinical symptoms, microbiological culture findings and pertinent laboratory tests. A rigorous statistical methodology employing IBM's SPSS version 27.0 was utilised for data analysis. In a univariate analysis, significant risk factors for post‐craniotomy SSIs were identified, with patients aged over 60 displaying a pronounced susceptibility. Moreover, surgeries exceeding a duration of 4 h heightened infection risks. Elevated ASA grades denoted an increased prevalence of SSIs, as did emergency procedures and higher National Nosocomial Infections Surveillance scores. Multivariate analysis pinpointed epidural/subdural drainage as a protective measure against SSIs, whereas emergency surgeries, operative times beyond 4 h and subsequent surgeries within the hospital stay amplified infection risks. Notably, coagulase‐negative Staphylococcus dominated the identified pathogens at 28.09%, followed by Escherichia coli (17.98%), Klebsiella pneumoniae (10.11%) and Staphylococcus aureus (11.24%), underscoring the need for diverse prophylactic measures. SSIs following craniotomies present a multifaceted challenge influenced by a confluence of patient‐related, operative and post‐operative determinants. Understanding these risk factors is paramount in refining surgical protocols and post‐operative care strategies to mitigate SSI incidence.

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“…Comparison of results between different studies remains difficult primarily because of differences in patient-case mix and methodology. Previous studies found that the incidence of HAI in non-Ukraine neurosurgical hospitals was from 1.3-11.1% [16][17][18][19][20][21][22], although data are heterogeneous due to use of different definitions for infections, and variable exclusion of culture-negative results, making a true estimate of prevalence difficult. In our study, the overall prevalence of neurosurgical patients with HAI was 20.9%.…”

Section: Discussionmentioning

confidence: 99%

Healthcare-Associated Infection in Neurosurgical Patients in Ukraine: Results of a Multicenter Study (2017-2019)

Salmanov¹,

Shchehlov²,

Svyrydiuk³

et al. 2021

Wiad Lek

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The aim: To obtain the estimates of the current prevalence of healthcare-associated infection among neurosurgical patients and determine the antimicrobial resistance of responsible pathogens in Ukraine. Materials and methods: We performed a retrospective multicenter cohort study was based on surveillance data of HAIs among neurosurgical patients from 2017 to 2019 in 7 regional hospitals. Definitions of HAI were used from the CDC/ NHSN. Results: Of 9,711 neurosurgical patients, 1,031 (20.9%) HAIs were observed. The most frequently of HAI types were surgical site infection (53.2%), pneumonia (17.3%), urinary tract infection (15.1%) and bloodstream infection (14.4%). The overall prevalence of HAIs was 20.9% within three months and was 12.8% during one month surveillance period. Death during hospitalization was reported in 11.3% of HAI cases. Escherichia coli were most commonly reported, accounting for 24.3% of all organisms, followed by Staphylococcus aureus (15.9%), Enterococcus spp (14.6%), Pseudomonas aeruginosa (13.4%), and Klebsiella pneumoniae (9.8%). Meticillin resistance was 34.6% of S.aureus isolates. Vancomycin resistance was in 7.1% of isolated enterococci. Among the gram-negative bacteria, third-generation cephalosporins resistance was found in 48.5% of K.pneumoniae and in 34.3% of E. coli isolates. Carbapenem resistance was reported in 11.7% of all included Enterobacteriaceae, also highest in K.pneumoniae, and in 32.4% of P.aeruginosa isolates and in 67.2% of Acinetobacter spp. isolates. Conclusions: Healthcare-associated infections are a cause for mortality and morbidity among hospitalized neurosurgical patients. This is due to increase emergence of antimicrobial-resistant pathogens. Routinely collected surveillance data are of great value as a basis for studying the consequences of HAIs.

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Incidence of surgical site infection after craniotomy: comparison between three months and twelve months of epidemiological surveillance

Abstract: The incidence of surgical site infection after craniotomy is high. Reducing the duration of the post-discharge surveillance period from 12 months to 3 months did not cause significant losses in the numbers of surgical site infection identified or a substantial decrease in their incidence.

Cited by 9 publications

References 10 publications

Epidemiology and Risk Factors of Post Operative Site Infections in Surgical Patients: A Systematic Review

Epidemiology and Risk Factors of Post Operative Site Infections in Surgical Patients: A Systematic Review

Comprehensive analysis of risk factors and pathogenetic characteristics associated with surgical site infections following craniotomy procedures

Healthcare-Associated Infection in Neurosurgical Patients in Ukraine: Results of a Multicenter Study (2017-2019)

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