Epidemiology and Microbiology of Healthcare-Associated Infections in Neurosurgery Department: A Cross-Sectional Study.

Abstract

Objective: Hospital-acquired infections (HAIs) present a significant challenge in neurosurgical settings. This study aimed to assess the prevalence, risk factors, and clinical impact of HAIs in a neurosurgery department. Methods: A retrospective cross-sectional study was conducted on 5474 patients hospitalized in a neurosurgery department (2019-2023). HAIs were diagnosed in 93 patients (2.7%), accounting for 147 infections. The final cohort included 273 patients: 93 with HAIs and 181 matched controls (age, sex, mortality). Demographic, clinical, and microbiological data were analyzed. Nutritional status was assessed using the Nutritional Risk Screening (NRS, 2002) and consciousness was assessed using the Glasgow Coma Scale (GCS). Infections were classified according to Centers for Disease Control and Prevention (CDC) criteria. Results: The most frequent HAIs were pneumonia (PN, 18.3%), bloodstream infections (BSI, 16.2%), and surgical site infections (SSI, 16.3%). Malnutrition (NRS ≥3) was significantly more common in infected patients (65.6% vs. 11%, p < .001). Patients with GCS ≤8 had higher rates of PN (44.7%) and urinary tract infections (UTI, 32.5%) (p = .004), while GCS 13-15 was linked to SSI (91.7%). HAIs occurred more frequently after emergency procedures (57.8% vs. 30%, p < .0001). Hospital stay was significantly longer in infected patients (40 vs. 5.4 days, p = .001). Klebsiella pneumoniae (15.1%) and Staphylococcus aureus (11.5%) were the most common. Age and sex were not significant risk factors. Conclusion: HAIs in neurosurgical patients are associated with malnutrition and procedural urgency. Targeted infection control, early nutrition support, and antimicrobial stewardship are essential to improving outcomes.