Infections in patients with traumatic brain injury who undergo neurosurgery
| Autor: | Antonis Ioannou, Christodoulos Neophytou, George Bertsias, Maria Anastasaki, Maria Filippou, Irene S Kourbeti, Antonis Vakis, Dimitris A. Karabetsos, John A. Papadakis |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Traumatic brain injury Urinary system Malignancy Neurosurgical Procedures Young Adult Risk Factors medicine Humans Surgical Wound Infection Respiratory Tract Infections Aged Retrospective Studies Aged 80 and over Cross Infection Greece Respiratory tract infections business.industry Head injury General Medicine Middle Aged medicine.disease Surgery Brain Injuries Concomitant Female Neurology (clinical) Neurosurgery business Meningitis |
| Zdroj: | British Journal of Neurosurgery. 25:9-15 |
| ISSN: | 1360-046X 0268-8697 |
| Popis: | Several factors place victims with traumatic brain injury (TBI) at increased risk for infection. The purpose of this study was to delineate the frequency, types and risk factors for infection in patients with TBI who undergo neurosurgery.Retrospective surveillance of infections in patients with TBI, aged ≥18 years who underwent neurosurgery in University of Crete between 1999 and 2005.Two hundred fifty-eight patients (76.7% men) who underwent 342 procedures were included. One hundred forty-two infections occurred, mainly lower respiratory tract infections (44.4% of the number of infections) and surgical site infections (SSIs) (25.4%). In multivariate analysis, SSIs were independently associated with the length of stay (p 0.001), history of malignancy (p = 0.008), CSF leak (p = 0.012), any concomitant infection (p = 0.010), particularly urinary tract infections (p = 0.001) and the use of lumbar and/or ventricular drains (p = 0.005). Meningitis was independently associated with the total length of stay (p 0.001), the need for intubation and mechanical ventilation beyond surgery (p = 0.028) and the presence of a lumbar and/or ventricular drain (p 0.001).Respiratory tract infections were common in patients with TBI who underwent surgery with Acinetobacter spp. being the emerging offending pathogens. Device-related postoperative communication of the CSF and the environment was a significant risk factor for SSI development and meningitis in particular. Malignancy was an independent risk factor for SSIs. The prevalence of the offending pathogens must be determined institution by institution for the establishment of proper antibiotic treatment on suspicion. |
| Databáze: | OpenAIRE |
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