gms | German Medical Science

Objective: The characteristics of nosocomial infections (NI) in an intermediate care unit of our neurosurgical department were studied over a 3 year period (2006–2008).

Methods: During this period, 352 patients (64.9±0.8 years old) were hospitalized in the unit with a stay longer than 48 hours (10.4± 0.2 day).

Results: The most common underlying neurosurgical pathologies were subarachnoid as well as intracranial hemorrhage and intracranial tumors. The rate of NI was 14.1%, 15.2%, and 20.4% in 2006, 2007, and 2008, respectively (average 16,7%; 59 of 352 patients developed a NI). Broncho-pulmonary and urinary tract infection followed by sepsis and CNS infection were the most common types of infection. Coagulase-negative staphylococcus was the most commonly isolated pathogens (30.4% of isolates) followed by Enterococcus, E.Coli, and Enterobacter. For all the pathogens isolated, the average rate of resistance to commonly used antimicrobial agents was 40%. Coronary disease (64.3%) was the most common risk factor in these patients followed by previous cranial surgery and renal disorders. In addition, the incidence of methicillin-resistant staphylococcus aureus (MRSA) colonization appears to be increasing (6 in 2006, 8 in 2007, 15 in 2008, 23 in 2009). Fortunately, the effect of MRSA infection on morbidity in hospitalized neurosurgical patients remains low.

Conclusions: These data may help to guide prevention strategies and other quality improvement efforts aimed at reducing NI rates as much as possible in neurosurgery departments.