Infections in traumatic brain injury patients
| Autor: | Maria Filippou, George Bertsias, Irene S Kourbeti, Antonis Vakis, C. Neophytou, Dimitris A. Karabetsos, George Samonis, M. Anastasaki, A. Ioannou, J.A. Papadakis |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Microbiology (medical) medicine.medical_specialty Time Factors Traumatic brain injury Respiratory Tract Diseases Young Adult Postoperative Complications Risk Factors Internal medicine Prevalence medicine Humans Surgical Wound Infection infections Aged Retrospective Studies Acinetobacter Greece Respiratory tract infections business.industry Head injury meningitis Retrospective cohort study General Medicine Middle Aged medicine.disease Surgery Hospitalization Treatment Outcome trauma Infectious Diseases Brain Injuries Concomitant Multivariate Analysis Female Neurosurgery business Meningitis Cohort study |
| Zdroj: | Clinical Microbiology and Infection. 18(4):359-364 |
| ISSN: | 1198-743X |
| DOI: | 10.1111/j.1469-0691.2011.03625.x |
| Popis: | Traumatic brain injury (TBI) victims are considered to be at high risk for infection. The purpose of this cohort study was to delineate the rates, types and risk factors for infection in TBI patients. Retrospective surveillance of infections was conducted for all TBI patients, aged ≥18 years, cared for at the Department of Neurosurgery of the University Hospital of Heraklion, Greece, between 1999 and 2005. A total of 760 patients (75% men) with a median age of 41 years were included. Most (59%) were injured in a motor vehicle accident. One third of them underwent a surgical procedure. Two hundred and fourteen infections were observed. The majority were infections of the lower respiratory tract (47%), followed by surgical site infections (SSI) (17%). Multivariate analysis showed that SSI development was independently associated with the performance of ≥2 surgical procedures (OR 16.7), presence of concomitant infections, namely VAP (OR 5.7) and UTI (OR 8.8), insertion of lumbar (OR 34.5) and ventricular drains (OR 4.0), and cerebrospinal fluid (CSF) leak (OR 3.8). Development of meningitis was associated with prolonged hospitalization (OR 1.02), especially >7 days ICU stay (OR 25.5), and insertion of lumbar (OR 297) and ventricular drains (OR 9.1). There was a notable predominance of Acinetobacter spp. as a VAP pathogen; gram-positive organisms remained the most prevalent in SSI cases. Respiratory tract infections were the most common among TBI patients. Device-related communication of the CSF with the environment and prolonged hospitalization, especially in the ICU setting, were independent risk factors for SSIs and meningitis cases. |
| Databáze: | OpenAIRE |
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