Ribeiro Bruno Barbosa, Pereira Raquel Duro, Vaz Rui, Carvalho Bruno, Pereira Nuno Rocha
Faculty of Medicine, University of Porto.
Antimicrobial Resistance and Infection Prevention and Control Unit, Epidemiology Centre, Centro Hospitalar Universitário São João.
Porto Biomed J. 2022 May 18;7(2):e152. doi: 10.1097/j.pbj.0000000000000152. eCollection 2022 Mar-Apr.
The incidence of surgical site infection after craniotomy (SSI-CRAN) varies widely and is associated with major consequences. The aim of this study is to estimate the SSI-CRAN rate at the neurosurgery department of a tertiary center and to establish its risk factors.
All consecutive adult patients who underwent elective craniotomy for tumor resection at a tertiary center from January 2018 to October 2019 were retrospectively assessed. Demographic, clinical, and surgical data were collected. The main outcome of our study was the development of SSI within 30days postsurgery, as defined by the European Centre for Disease Prevention and Control guidelines. Univariate and multivariate analyses were performed to establish risk factors for SSI-CRAN.
From the 271 patients enrolled in this study, 15 (5.5%) developed SSI-CRAN within 30days postsurgery, 11 (73.3%) of which were organ-space. The most common causative microorganisms isolated were gram-positive cocci, particularly Staphylococcus (n 4, 66.7%). In the univariate analysis, absence of normothermia and cerebrospinal fluid (CSF) leak were associated with SSI-CRAN. In the multivariate analysis, normothermia was the only protective factor and CSF leak was the only independent risk factor for SSI-CRAN.
The cumulative incidence of SSI-CRAN within 30days postsurgery was 5.5%. CSF leak and the absence of normothermia were the only independent risk factors for SSI-CRAN. The data provided in this study should be considered in the design of preventive strategies aimed to reduce the incidence of SSI.
开颅术后手术部位感染（SSI-CRAN）的发生率差异很大，且会带来严重后果。本研究的目的是评估一家三级中心神经外科的SSI-CRAN发生率，并确定其危险因素。
对2018年1月至2019年10月在一家三级中心接受择期开颅肿瘤切除术的所有连续成年患者进行回顾性评估。收集人口统计学、临床和手术数据。我们研究的主要结局是术后30天内发生的SSI，按照欧洲疾病预防控制中心的指南进行定义。进行单因素和多因素分析以确定SSI-CRAN的危险因素。
在本研究纳入的271例患者中，15例（5.5%）在术后30天内发生了SSI-CRAN，其中11例（73.3%）为器官腔隙感染。分离出的最常见致病微生物是革兰氏阳性球菌，尤其是葡萄球菌（n = 4，66.7%）。在单因素分析中，体温未恢复正常和脑脊液（CSF）漏与SSI-CRAN相关。在多因素分析中，体温恢复正常是唯一的保护因素，CSF漏是SSI-CRAN唯一的独立危险因素。
术后30天内SSI-CRAN的累积发生率为5.5%。CSF漏和体温未恢复正常是SSI-CRAN仅有的独立危险因素。在设计旨在降低SSI发生率的预防策略时，应考虑本研究提供的数据。
