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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

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Interdisciplinary infection prevention and control bundle including sonication decreases sepsis and in-hospital mortality in neurosurgical patients – results of a prospective cohort study

Interdisziplinäres Bündel zur Infektionsprävention und -kontrolle einschließlich Sonikation verringert Sepsis und Sterblichkeit im Krankenhaus bei neurochirurgischen Patienten: Ergebnisse einer prospektiven Kohortenstudie

Meeting Abstract

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  • Julia Koch - Charité – Universitätsmedizin Berlin, Klinik für Neurochirurgie, Berlin, Deutschland
  • Selin Saydan - Charité – Universitätsmedizin Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Deutschland
  • Frank Schwab - Charité – Universitätsmedizin Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Deutschland
  • presenting/speaker Aminaa Sanchin - Charité – Universitätsmedizin Berlin, Klinik für Neurochirurgie, Berlin, Deutschland
  • Sonja Hansen - Charité – Universitätsmedizin Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Deutschland; National Reference Center for Surveillance of Nosocomial Infections, Berlin, Deutschland
  • Andrej Trampuz - Charité – Universitätsmedizin Berlin, Center for Musculoskeletal Surgery, Berlin, Deutschland
  • Donara Margaryan - Charité – Universitätsmedizin Berlin, Center for Musculoskeletal Surgery, Berlin, Deutschland
  • Peter Vajkoczy - Charité – Universitätsmedizin Berlin, Klinik für Neurochirurgie, Berlin, Deutschland
  • Julia Sophie Onken - Charité – Universitätsmedizin Berlin, Klinik für Neurochirurgie, Berlin, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV096

doi: 10.3205/22dgnc098, urn:nbn:de:0183-22dgnc0982

Veröffentlicht: 25. Mai 2022

© 2022 Koch et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Surgical site infections (SSI) account for one of the most common causes of nosocomial infections leading to increased morbidity and mortality. Here we report the clinical impact of an infection prevention and control bundle (IPCB) with focus on the morbidity and mortality in neurosurgical patients experiencing SSI.

Methods: From 2014 to 2019, cases of patients who developed a SSI following neurosurgical intervention were recorded prospectively in the national surveillance program for nosocomial infections. Three time periods were examined: 2014 (prior to implementation of IPCB), 2017 (introduction of IPCB), and 2019 (full implementation of IPCB). Primary outcome parameters were repeated revision surgeries due to SSI, pathogen detection rate and morbidity and mortality following SSI.

Results: The IPCB was designed interdisciplinarily. The compliance of IPCB measures was monitored and reached >80–90% in 2019. Pathogen isolation succeeded more frequently over time n=138 in 2014, n=169 in 2017 and n=199 in 2019. Repeated revision surgeries decreased from 26 (20%) in 2014 and 31 (23%) in 2017 to 18 (13%) in 2019 (p=0.085). Significantly fewer patients experienced a sepsis in response to SSI over time (2014: 12%, 2017: 10%, 2019: 3.6%, p=0.035). Corresponding to that, the in-hospital mortality rate was declining from 12 (9.4%) in 2014 to 9 (6.6%) in 2017 to 5 (3.6%) in 2019 (p=0.148).

Conclusion: Introducing an IPCB in neurosurgery led to a significant reduction of sepsis and a decreased in-hospital mortality. Minimization of the diagnostic gap towards a more efficient anti-infective treatment might be the reason for the substantial decrease in morbidity and mortality in this cohort.