颅内神经外科手术后手术部位感染与哪些因素相关？探索性语域研究

IF 3.9 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection Pub Date : 2025-03-08 DOI:10.1016/j.jhin.2025.02.013

I-L. Böregård , L. Arvidsson , S. Bringman , C. Leo Swenne , A-C. von Vogelsang

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引用次数: 0

摘要

背景：颅内神经外科手术后手术部位感染（ssi）可由内源性和外源性因素引起，并与发病率、死亡率增加和额外的社会经济成本相关。在手术室通风中增加移动层流（MLAF）装置可减少携带细菌的颗粒，但其对SSI发生率的影响以及与其他因素的协同作用尚不清楚。这是先前使用MLAF单位的研究的延续研究。目的：探讨在使用MLAF装置期间颅内手术后手术部位感染的相关因素。方法：采用探索性设计的回顾性研究。采用45项方案，回顾性回顾了接受颅内神经外科手术的患者的电子病历，以寻找ssi的体征或症状。收集了人口统计学、患者和手术特定变量，以及有关深度、细菌类型、感染时间和治疗的外源性因素和SSI变量。数据分析采用单因素和多因素logistic回归。结果：800例纳入的患者中有55例（6.9%）发生SSI。在单因素和多因素分析中，只有住院期间的远程感染与SSI的风险相关(OR: 2.02；95% ci: 1.07-3.82；P = 0.031)。最常见的感染深度是浅表ssi。感染的平均时间为18天，最主要的微生物是金黄色葡萄球菌。结论：在临床背景下，建议神经外科患者在住院期间考虑持续的远程感染。围手术期预防手术感染的研究还有待进一步深入。

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What factors are associated with surgical site infections after intracranial neurosurgical procedures? An exploratory register study

Background

Surgical site infections (SSIs) after intracranial neurosurgical procedures derive from both endogenous and exogenous factors, and are associated with increased morbidity, mortality and additional socio-economic costs. The addition of mobile laminar airflow (MLAF) units to the operating room ventilation decreases bacteria-carrying particles, but their influence on the incidence of SSIs, and concurrence with other factors, is unclear. This is a continuation study of a previous study using MLAF units.

Aim

To explore factors associated with SSIs after intracranial procedures during a period when MLAF units were used.

Methods

This retrospective register study had an explorative design. The electronic medical records of patients undergoing intracranial neurosurgical procedures were reviewed retrospectively for signs or symptoms of SSIs using a 45-item protocol. Demographic, patient-specific and procedure-specific variables were collected, as well as exogenous factors and SSI variables regarding depth of SSI, type of bacteria, time to infection, and treatment. Data were analysed using univariate and multi-variate logistic regression.

Findings

An SSI occurred in 55 of 800 included patients (6.9%). On univariate and multi-variate analysis, only remote infections during the hospital stay were associated with risk of SSI (odds ratio 2.02, 95% confidence interval 1.07–3.82; P=0.031). Superficial SSIs were most common, the median time to infection was 18 days, and the most common causative micro-organism was Staphylococcus aureus.

Conclusions

In the clinical context, considerations are recommended for neurosurgical patients with ongoing remote infections during their hospital stay. Further peri-operative studies are needed in the field of surgical infection prevention.

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来源期刊

Journal of Hospital Infection 医学-传染病学

CiteScore

12.70

自引率

5.80%

发文量

271

审稿时长

19 days

期刊介绍： The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.