YiYao Cao1, Ke Pu2, Guodong Li1, XueJiang Yan3, Yue Ma3, Kai Xue3, ZhiMing Sun3, QingGuo Li4. 1. Graduate School of Tianjin Medical University, Tianjin, China; Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, China. 2. Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, China; Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Disease, Tianjin Neurosurgical Institute, Tianjin, China. 3. Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, China. 4. Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, China; Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Disease, Tianjin Neurosurgical Institute, Tianjin, China. Electronic address: lqg369@126.com.
Abstract
OBJECTIVE: To investigate the efficacy of antibiotic prophylaxis (AP) and the risk factors for postoperative infections in clean neurosurgery. METHODS: Data were retrospectively collected on all patients who had undergone clean neurosurgical operation at our institution between January 2009 and December 2014. From January 2009 until October 2011, AP was administered to every clean neurosurgical patient. From November 2011 to December 2014, no AP (n-AP) was prescribed for all clean neurosurgical operations. The efficacy of AP and independent risk factors for infection were studied. RESULTS: A total of 808 clean neurosurgical cases were included. The AP group comprised 360 surgical cases, including 29 meningitis cases and 2 cases of incision infections, whereas the n-AP group consisted of 448 surgical cases, including 35 meningitis cases and 4 cases of incision infections (P = 0.848). Microorganisms were identified in 7 of 29 cases in the AP group compared with their identification in 22 of 35 cases in the n-AP group (P = 0.002). The percentage of patients with multidrug-resistant bacterial meningitis in the AP group was 57.1% compared with 13.6% in the n-AP group (P = 0.038). The risk factors for postoperative infection were cerebrospinal fluid leakage (odds ratio, 27.8; 95% confidence interval, 9.38-28.55) and surgery time (odds ratio, 1.12; 95% confidence interval, 1.02-1.22). CONCLUSIONS: Our results show that in our data set, AP had no preventive effect on postoperative infections in clean neurosurgery. In addition, AP appeared to decrease the positive bacterial culture rate and to promote the emergence of multidrug-resistant bacteria. Cerebrospinal fluid leakage and surgery time were the risk factors for postoperative infection.
OBJECTIVE: To investigate the efficacy of antibiotic prophylaxis (AP) and the risk factors for postoperative infections in clean neurosurgery. METHODS: Data were retrospectively collected on all patients who had undergone clean neurosurgical operation at our institution between January 2009 and December 2014. From January 2009 until October 2011, AP was administered to every clean neurosurgical patient. From November 2011 to December 2014, no AP (n-AP) was prescribed for all clean neurosurgical operations. The efficacy of AP and independent risk factors for infection were studied. RESULTS: A total of 808 clean neurosurgical cases were included. The AP group comprised 360 surgical cases, including 29 meningitis cases and 2 cases of incision infections, whereas the n-AP group consisted of 448 surgical cases, including 35 meningitis cases and 4 cases of incision infections (P = 0.848). Microorganisms were identified in 7 of 29 cases in the AP group compared with their identification in 22 of 35 cases in the n-AP group (P = 0.002). The percentage of patients with multidrug-resistant bacterial meningitis in the AP group was 57.1% compared with 13.6% in the n-AP group (P = 0.038). The risk factors for postoperative infection were cerebrospinal fluid leakage (odds ratio, 27.8; 95% confidence interval, 9.38-28.55) and surgery time (odds ratio, 1.12; 95% confidence interval, 1.02-1.22). CONCLUSIONS: Our results show that in our data set, AP had no preventive effect on postoperative infections in clean neurosurgery. In addition, AP appeared to decrease the positive bacterial culture rate and to promote the emergence of multidrug-resistant bacteria. Cerebrospinal fluid leakage and surgery time were the risk factors for postoperative infection.
Authors: Emilio Garzón Cediel; Varina Louise Boerwinkle; Juan Fernando Ramon; Diana Arias; Jose Antonio De la Hoz-Valle; Jose Dario Mercado; Darwin Cohen; Maria Claudia Niño Journal: Surg Neurol Int Date: 2022-03-04