Incidence and microbiology of surgical site infection in cranial neurosurgery in recent era: Single institutional consecutive series and review of literature

Background: Surgical site infection (SSI) is the most common healthcare-associated infection. Neurosurgical SSI results in severe morbidity and high mortality. This study aims to review our insti-tutional series of SSIs after cranial surgery, identify risk factors and pathogens, and enhance surgical outcomes through literature review. Materials and Methods: A retrospective, single-institutional study was conducted, craniotomy and craniectomy from January 2021 to December 2022 were included. Risk factors of all cases and pathogens, treatments, and outcomes of infected cases were collected and statistically analyzed. Results: Out of total 391 cases, 8 cases (2.0%) from six different type of surgeries, and diseases were diagnosed SSI. Four different pathogens were isolated, but pathogen was not identified in 4 cases (50.0%). The isolated pathogens included methicillin-sensitive Staphylococcus aureus , methicillin-resistant S. aureus , Bacillus cereus , and multi-drug resistant Acinetobacter baumannii . Among the eight cases, there were 2 cases (25.0%) of superficial SSI, 4 cases (50.0%) of deep SSI, and 2 cases (25.0%) of organ/space SSI. Two cases (25.0%) were managed with antibiotics alone, abscess was drained in 2 cases (25.0%), and revisional surgery was conducted in 4 cases (50.0%). Conclusions: Out of the 8 cases of SSI, a half of the isolated strains were multi-drug resistant. All infections were successfully treated without complications. However, guidelines for treatment of neu-rosurgical site infection were insufficient. The increasing prevalence of multi-drug resistant bacterial infection underscores the necessity of treatment consensus for the future.