Surgical site infections following craniotomy focusing on possible post-operative acquisition of infection: prospective cohort study
Neurosurgery is characterized by a prolonged risk period for surgical site infection (SSI), mainly related to the presence of cerebrospinal fluid (CSF) drains. We aimed to examine factors associated with post-neurosurgical SSIs, focusing on post-operative factors. A prospective cohort study was cond...
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| Veröffentlicht in: | European journal of clinical microbiology & infectious diseases 2013-12, Vol.32 (12), p.1511-1516 |
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| creator | Sneh-Arbib, O. Shiferstein, A. Dagan, N. Fein, S. Telem, L. Muchtar, E. Eliakim-Raz, N. Rubinovitch, B. Rubin, G. Rappaport, Z. H. Paul, M. |
| description | Neurosurgery is characterized by a prolonged risk period for surgical site infection (SSI), mainly related to the presence of cerebrospinal fluid (CSF) drains. We aimed to examine factors associated with post-neurosurgical SSIs, focusing on post-operative factors. A prospective cohort study was conducted in a single center over a period of 18 months in Israel. Included were adult patients undergoing clean or clean-contaminated craniotomy, including craniotomies with external CSF drainage or shunts. SSIs were defined by the Centers for Disease Control and Prevention (CDC) criteria for healthcare-associated infections. All patients were followed up for 90 days and those with foreign body insertion for 1 year. We compared patients with and without SSI. A multivariable regression analysis for SSI was conducted including uncorrelated variables significantly associated with SSI. A total of 502 patients were included, with 138 (27.5 %) undergoing emergent or urgent craniotomy. The overall SSI rate was 5.6 % (28 patients), of which 3.2 % (16 patients) were intracerebral. Non-elective surgery, external CSF drainage/monitoring devices, re-operation, and post-operative respiratory failure were independently associated with subsequent SSI. External CSF devices was the only significant risk factor for intracerebral SSIs (
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| doi_str_mv | 10.1007/s10096-013-1904-y |
| format | Article |
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p
< 0.001). Internal shunts or other foreign body insertions were not associated with SSIs. A phenotypically identical isolate to that causing the SSI was isolated from respiratory secretions prior to the SSI in 4/9 patients with microbiologically documented intracerebral SSIs. Patients with SSIs had longer hospital stay, poorer functional capacity on discharge, and higher 90-day mortality. We raise the possibility of post-operative infection acquisition through external CSF devices. Standard operating procedures for their maintenance are necessary.</description><identifier>ISSN: 0934-9723</identifier><identifier>EISSN: 1435-4373</identifier><identifier>DOI: 10.1007/s10096-013-1904-y</identifier><identifier>PMID: 23754309</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Abscesses ; Adult ; Aged ; Antibiotics ; Biological and medical sciences ; Biomedical and Life Sciences ; Biomedicine ; Cerebrospinal fluid ; Cohort analysis ; Craniotomy - adverse effects ; Craniotomy - statistics & numerical data ; Disease control ; Disease prevention ; Female ; Foreign bodies ; General aspects ; Hospitals ; Human infectious diseases. Experimental studies and models ; Humans ; Infectious diseases ; Internal Medicine ; Israel - epidemiology ; Male ; Medical Microbiology ; Medical sciences ; Meningitis ; Middle Aged ; Mortality ; Multivariate Analysis ; Neurosurgery ; Patients ; Prospective Studies ; Regression analysis ; Risk Factors ; Surgical site infections ; Surgical Wound Infection - epidemiology ; Surgical Wound Infection - etiology</subject><ispartof>European journal of clinical microbiology & infectious diseases, 2013-12, Vol.32 (12), p.1511-1516</ispartof><rights>Springer-Verlag Berlin Heidelberg 2013</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c468t-22da103a3a43718d8b367460b39ec6376740d3db81698652f9304a3bd6c46bee3</citedby><cites>FETCH-LOGICAL-c468t-22da103a3a43718d8b367460b39ec6376740d3db81698652f9304a3bd6c46bee3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10096-013-1904-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10096-013-1904-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27967608$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23754309$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sneh-Arbib, O.</creatorcontrib><creatorcontrib>Shiferstein, A.</creatorcontrib><creatorcontrib>Dagan, N.</creatorcontrib><creatorcontrib>Fein, S.</creatorcontrib><creatorcontrib>Telem, L.</creatorcontrib><creatorcontrib>Muchtar, E.</creatorcontrib><creatorcontrib>Eliakim-Raz, N.</creatorcontrib><creatorcontrib>Rubinovitch, B.</creatorcontrib><creatorcontrib>Rubin, G.</creatorcontrib><creatorcontrib>Rappaport, Z. H.</creatorcontrib><creatorcontrib>Paul, M.</creatorcontrib><title>Surgical site infections following craniotomy focusing on possible post-operative acquisition of infection: prospective cohort study</title><title>European journal of clinical microbiology & infectious diseases</title><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><description>Neurosurgery is characterized by a prolonged risk period for surgical site infection (SSI), mainly related to the presence of cerebrospinal fluid (CSF) drains. We aimed to examine factors associated with post-neurosurgical SSIs, focusing on post-operative factors. A prospective cohort study was conducted in a single center over a period of 18 months in Israel. Included were adult patients undergoing clean or clean-contaminated craniotomy, including craniotomies with external CSF drainage or shunts. SSIs were defined by the Centers for Disease Control and Prevention (CDC) criteria for healthcare-associated infections. All patients were followed up for 90 days and those with foreign body insertion for 1 year. We compared patients with and without SSI. A multivariable regression analysis for SSI was conducted including uncorrelated variables significantly associated with SSI. A total of 502 patients were included, with 138 (27.5 %) undergoing emergent or urgent craniotomy. The overall SSI rate was 5.6 % (28 patients), of which 3.2 % (16 patients) were intracerebral. Non-elective surgery, external CSF drainage/monitoring devices, re-operation, and post-operative respiratory failure were independently associated with subsequent SSI. External CSF devices was the only significant risk factor for intracerebral SSIs (
p
< 0.001). Internal shunts or other foreign body insertions were not associated with SSIs. A phenotypically identical isolate to that causing the SSI was isolated from respiratory secretions prior to the SSI in 4/9 patients with microbiologically documented intracerebral SSIs. Patients with SSIs had longer hospital stay, poorer functional capacity on discharge, and higher 90-day mortality. We raise the possibility of post-operative infection acquisition through external CSF devices. Standard operating procedures for their maintenance are necessary.</description><subject>Abscesses</subject><subject>Adult</subject><subject>Aged</subject><subject>Antibiotics</subject><subject>Biological and medical sciences</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cerebrospinal fluid</subject><subject>Cohort analysis</subject><subject>Craniotomy - adverse effects</subject><subject>Craniotomy - statistics & numerical data</subject><subject>Disease control</subject><subject>Disease prevention</subject><subject>Female</subject><subject>Foreign bodies</subject><subject>General aspects</subject><subject>Hospitals</subject><subject>Human infectious diseases. Experimental studies and models</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Internal Medicine</subject><subject>Israel - epidemiology</subject><subject>Male</subject><subject>Medical Microbiology</subject><subject>Medical sciences</subject><subject>Meningitis</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Neurosurgery</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Regression analysis</subject><subject>Risk Factors</subject><subject>Surgical site infections</subject><subject>Surgical Wound Infection - epidemiology</subject><subject>Surgical Wound Infection - etiology</subject><issn>0934-9723</issn><issn>1435-4373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kc-P1SAQx4nRuM_VP8CLITEme0GhQ6F422z8lWziQT03lNInm77SBbqmd_9wp3lP15h4AWb4zJcZvoQ8F_y14Fy_ybgaxbgAJgyXbH1AdkJCzSRoeEh23IBkRldwRp7kfMOxptH6MTmrQNcSuNmRn1-WtA_OjjSH4mmYBu9KiFOmQxzH-CNMe-qSnUIs8bBi0i15y8WJzjHn0I1-OxQWZ59sCXeeWne7BFRDFRqHe8m3dE4xz1uAlIvfYyo0l6Vfn5JHgx2zf3baz8m39---Xn1k158_fLq6vGZOqqawquqt4GDB4nyi6ZsOlJaKd2C8U6Ax4D30XSOUaVRdDQa4tND1Cus77-GcXBx1sZHbxefSHkJ2fhzt5OOSWyFrLrTWjUD05T_oTVzShN0hJY2UNUCFlDhSDifLyQ_tnMLBprUVvN0sao8WtWhRu1nUrljz4qS8dAff_6n47QkCr06AzWjMgL_vQr7ntFFa8Qa56shlvJr2Pv3V4n9f_wUSN6vf</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Sneh-Arbib, O.</creator><creator>Shiferstein, A.</creator><creator>Dagan, N.</creator><creator>Fein, S.</creator><creator>Telem, L.</creator><creator>Muchtar, E.</creator><creator>Eliakim-Raz, N.</creator><creator>Rubinovitch, B.</creator><creator>Rubin, G.</creator><creator>Rappaport, Z. H.</creator><creator>Paul, M.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20131201</creationdate><title>Surgical site infections following craniotomy focusing on possible post-operative acquisition of infection: prospective cohort study</title><author>Sneh-Arbib, O. ; Shiferstein, A. ; Dagan, N. ; Fein, S. ; Telem, L. ; Muchtar, E. ; Eliakim-Raz, N. ; Rubinovitch, B. ; Rubin, G. ; Rappaport, Z. H. ; Paul, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c468t-22da103a3a43718d8b367460b39ec6376740d3db81698652f9304a3bd6c46bee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Abscesses</topic><topic>Adult</topic><topic>Aged</topic><topic>Antibiotics</topic><topic>Biological and medical sciences</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Cerebrospinal fluid</topic><topic>Cohort analysis</topic><topic>Craniotomy - adverse effects</topic><topic>Craniotomy - statistics & numerical data</topic><topic>Disease control</topic><topic>Disease prevention</topic><topic>Female</topic><topic>Foreign bodies</topic><topic>General aspects</topic><topic>Hospitals</topic><topic>Human infectious diseases. Experimental studies and models</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Internal Medicine</topic><topic>Israel - epidemiology</topic><topic>Male</topic><topic>Medical Microbiology</topic><topic>Medical sciences</topic><topic>Meningitis</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Neurosurgery</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Regression analysis</topic><topic>Risk Factors</topic><topic>Surgical site infections</topic><topic>Surgical Wound Infection - epidemiology</topic><topic>Surgical Wound Infection - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sneh-Arbib, O.</creatorcontrib><creatorcontrib>Shiferstein, A.</creatorcontrib><creatorcontrib>Dagan, N.</creatorcontrib><creatorcontrib>Fein, S.</creatorcontrib><creatorcontrib>Telem, L.</creatorcontrib><creatorcontrib>Muchtar, E.</creatorcontrib><creatorcontrib>Eliakim-Raz, N.</creatorcontrib><creatorcontrib>Rubinovitch, B.</creatorcontrib><creatorcontrib>Rubin, G.</creatorcontrib><creatorcontrib>Rappaport, Z. 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H.</au><au>Paul, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical site infections following craniotomy focusing on possible post-operative acquisition of infection: prospective cohort study</atitle><jtitle>European journal of clinical microbiology & infectious diseases</jtitle><stitle>Eur J Clin Microbiol Infect Dis</stitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><date>2013-12-01</date><risdate>2013</risdate><volume>32</volume><issue>12</issue><spage>1511</spage><epage>1516</epage><pages>1511-1516</pages><issn>0934-9723</issn><eissn>1435-4373</eissn><abstract>Neurosurgery is characterized by a prolonged risk period for surgical site infection (SSI), mainly related to the presence of cerebrospinal fluid (CSF) drains. We aimed to examine factors associated with post-neurosurgical SSIs, focusing on post-operative factors. A prospective cohort study was conducted in a single center over a period of 18 months in Israel. Included were adult patients undergoing clean or clean-contaminated craniotomy, including craniotomies with external CSF drainage or shunts. SSIs were defined by the Centers for Disease Control and Prevention (CDC) criteria for healthcare-associated infections. All patients were followed up for 90 days and those with foreign body insertion for 1 year. We compared patients with and without SSI. A multivariable regression analysis for SSI was conducted including uncorrelated variables significantly associated with SSI. A total of 502 patients were included, with 138 (27.5 %) undergoing emergent or urgent craniotomy. The overall SSI rate was 5.6 % (28 patients), of which 3.2 % (16 patients) were intracerebral. Non-elective surgery, external CSF drainage/monitoring devices, re-operation, and post-operative respiratory failure were independently associated with subsequent SSI. External CSF devices was the only significant risk factor for intracerebral SSIs (
p
< 0.001). Internal shunts or other foreign body insertions were not associated with SSIs. A phenotypically identical isolate to that causing the SSI was isolated from respiratory secretions prior to the SSI in 4/9 patients with microbiologically documented intracerebral SSIs. Patients with SSIs had longer hospital stay, poorer functional capacity on discharge, and higher 90-day mortality. We raise the possibility of post-operative infection acquisition through external CSF devices. Standard operating procedures for their maintenance are necessary.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>23754309</pmid><doi>10.1007/s10096-013-1904-y</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0934-9723 |
| ispartof | European journal of clinical microbiology & infectious diseases, 2013-12, Vol.32 (12), p.1511-1516 |
| issn | 0934-9723 1435-4373 |
| language | eng |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Abscesses Adult Aged Antibiotics Biological and medical sciences Biomedical and Life Sciences Biomedicine Cerebrospinal fluid Cohort analysis Craniotomy - adverse effects Craniotomy - statistics & numerical data Disease control Disease prevention Female Foreign bodies General aspects Hospitals Human infectious diseases. Experimental studies and models Humans Infectious diseases Internal Medicine Israel - epidemiology Male Medical Microbiology Medical sciences Meningitis Middle Aged Mortality Multivariate Analysis Neurosurgery Patients Prospective Studies Regression analysis Risk Factors Surgical site infections Surgical Wound Infection - epidemiology Surgical Wound Infection - etiology |
| title | Surgical site infections following craniotomy focusing on possible post-operative acquisition of infection: prospective cohort study |
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