Individualized antibiotic prophylaxis reduces surgical site infections by gram-negative bacteria in instrumented spinal surgery

Abstract

Higher preoperative GNB colonization rates were found in patients with neurogenic bladder or indwelling catheters. Preoperative bacteriological screening, treatment for bacteriuria, and individualized antibiotic prophylaxis were effective for reducing GNB SSI.

Implant survival after deep infection of an instrumented spinal fusion

“…9 Over recent years, there has been an increasing number of publications about risk factors for SSI 12,13 and the prophylactic measures that should be taken. 14,15 Nevertheless, there is little available information about the effectiveness of the treatment of SSI and, in particular, the mid-and long-term outcome of patients with infected PSFI and the risk factors for an unfavourable outcome.…”

Single-use instrumentation in posterior lumbar fusion could decrease incidence of surgical site infection: a prospective bi-centric study

“…Numerous authors identified comorbidities that increase the risk of infection, including patient age, obesity, diabetes, urinary incontinence, tobacco use, poor nutrition, revision surgery, non-steroidal anti-inflammatory drugs, tumour resection, increased blood loss, and prolonged surgery time [4][5][6][7][8][9][10][11][12]. Other authors noted further increase in infection rates as the number of fused levels increases [2,13,14].…”

“…Studies published over the past decade on short posterior lumbar instrumentation for degenerative spine diseases report infection rates ranging from 4.2 to 13.8 % [1,13,[15][16][17][18][19][20]. Some studies demonstrated even lower infection rates using special measures: Ohtori et al [21] reported a rate of 1.2 % in a series of 82 patients that had fusion at a single level; Kim et al [19] reported a rate of 0 % in a series of 34 patients that had fusion at multiple levels using intra-wound vancomycin powder prophylaxis (12.5 % in control group); and Gruenberg et al [17] reported a rate of 0 % in 40 patients that had fusion at multiple levels operated under ultra-clean air technology (UCAT) laminar flow without prophylactic antibiotics (12.9 % in control group).…”

The use of antibiotic-impregnated fibrin sealant for the prevention of surgical site infection associated with spinal instrumentation

“…The costs of care can increase more than fourfold compared with those of uncomplicated cases [1]. Although the development of sterile surgical techniques, the prophylactic intravenous administration of antibiotics, the recognition of predisposing factors, and several advances in anti-infective technology have all contributed to decreasing the infection rates [2,3], SSIs still exist and remain difficult to treat. Therefore, a more effective means of preventing SSIs is the key to successful spinal surgery.…”