Abstract
Objective Infection following surgery is a serious complication, especially in neurosurgery.
The aim of the study is to report the change of incidence rates of infection in patients
undergoing elective neurosurgical procedures at a university hospital in South China
as well as the risk factors.
Material and Methods The medical records and postoperative courses for patients undergoing 1,033 neurosurgical
procedures from 2008 to 2014 were reviewed retrospectively to determine the incidence
of neurosurgical infection, the identity of the offending organisms, and the factors
associated with infection.
Results A total of 33 patients (40 cases) experienced postoperative infection representing
3.19% of the study population. Twenty cases were incision infections (1.94%), and
20 were cranial/spinal infections (1.94%) including 15 intracranial infections and
5 intraspinal infections. The 2.4-fold greater incidence of postoperative infection
in 2008 to 2010 was compared with that in 2011 to 2014 with perioperative antibiotic
prophylaxis (p <0.01). The neurosurgical procedure associated with the highest rate of infection
was cranioplasty (6.85%); the lowest rate of infection was associated with functional
neurosurgery (1.08%). The most common offending organism was Staphylococcus aureus (27.5%). Foreign body implantation, operative time > 4 hours, and cerebrospinal fluid
(CSF) leak (13 infections in 158 patients; p <0.001) were risk factors for infections (p <0.05).
Conclusion The neurosurgical infection rate is usually low with perioperative antibiotic prophylaxis
even in developing countries. Less foreign body implantation, shorter operative times,
and controlling CSF leak could reduce infection rates.
Keywords
elective neurosurgery - infection - antibiotic prophylaxis - risk factors
