gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Risk factors for surgical site infections in neurosurgery and the role of perioperative antibiotics

Meeting Abstract

  • F. Müller - Klinik für Geburtsmedizin, Charité, Campus Virchow-Klinikum, Berlin, Deutschland
  • M. Buchfelder - Klinik für Neurochirurgie, Friedrich-Alexander-Universität Nürnberg-Erlangen, Erlangen, Deutschland
  • V. Rohde - Klinik für Neurochirurgie, Georg-August-Universität Göttingen, Göttingen, Deutschland
  • A. Gutenberg - Klinik für Neurochirurgie, Georg-August-Universität Göttingen, Göttingen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocP 104

DOI: 10.3205/11dgnc325, URN: urn:nbn:de:0183-11dgnc3253

Published: April 28, 2011

© 2011 Müller et al.
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Outline

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Objective: This retrospective study aimed to determine the risk factors and bacteriological features of surgical site infections after neurosurgical procedures of the brain with special emphasis on perioperative antibiotic prophylaxis in preventing these infections

Methods: This study includes 918 patients who underwent a total of 1422 surgical procedures operated within a 26-month period. Pre-, intra- and postoperative variables such as patient age and risk factors, kind of craniotomy, emergency or elective surgery, duration of surgeries, and prolonged postoperative stay in the intensive care unit were correlated with the surgical infection rate.

Results: The overall infection rate was 6% for surgery-associated infections and 15.2% for general infections, e.g. pneumonia. Significant risk factors for surgery-associated infections were the duration of the surgical procedure, emergency surgery, postoperative length-of-stay in the intensive care unit for over 24 hours and the use of intracranial implants. 64% of the patients received antibiotic prophylaxis; a first-generation cephalosporin was most commonly administered. In patients receiving no antibiotics, the predominant bacteria were gram-negative, whereas patients receiving perioperative antibiotics most often suffered from infections by gram-positive bacteria. Although prophylactic antibiotic use significantly reduced the length of hospital stay (23 days vs. 28 days, p = 0.0003), it did not prevent postoperative infections.

Conclusions: Surgical site infections remain an important problem in neurosurgery. The identification of risk factors for surgical site infections is important for the quality assurance of any medical unit and will help improve patient care. The use of a single shot dose of perioperative antibiotics is a commonly employed method. Although it significantly reduced the length of hospital stay, it is not sufficient for preventing surgical site infections in neurosurgery.