Effect of risk-stratified, protocol-based perioperative chemoprophylaxis on nosocomial infection rates in a series of 31 927 consecutive neurosurgical procedures (1994-2006).

摘要: OBJECTIVE: Although the use of prophylactic antibiotics has been shown to significantly decrease incidence meningitis after neurosurgery, its effect on extra―neurosurgical-site infections not documented. The authors explore risk-stratified, protocol-based perioperative antibiotic prophylaxis nosocomial in an audit 31 927 consecutive routine and emergency neurosurgical procedures. METHODS: Infection rates were objectively quantified by bacteriological positivity culture cerebrospinal fluid (CSF), blood, urine, wound swab, tracheal aspirate samples derived from patients with clinicoradiological features sepsis. Infections recorded as pulmonary, wound, CSF, urinary. total numbers hospital-acquired number infected also recorded. A protocol variable duration stratified patient risk factors was introduced 2000, which chosen historical turning point. χ 2 test used compare infection rates. P value <0.05 considered significant. RESULTS: procedures performed during study period 1994―2006; 5171 culture-proven (16.2%) developed 3686 (11.6%). most common pulmonary (4.4%), followed bloodstream (3.5%), urinary (3.0%), CSF (2.9%), (2.5%). positive tracheal, urine cultures decreased 2000. Chemoprophylaxis, however, altered prevalent bacterial flora may have led emergence methicillin-resistant Staphylococcus aureus. CONCLUSION: risk-stratified help only neurosurgical, but body positivity.