Prospective Multicenter Surveillance Study of Surgical Site Infection after Intracranial Procedures in Korea : A Preliminary Study

J Korean Neurosurg Soc. 2018 Sep;61(5):645-652. doi: 10.3340/jkns.2018.0021. Epub 2018 Aug 31.

Abstract

Objective: This study aimed to investigate the rates, types, and risk factors of surgical site infection (SSI) following intracranial neurosurgical procedures evaluated by a Korean SSI surveillance system.

Methods: This was a prospective observational study of patients who underwent neurosurgical procedures at 29 hospitals in South Korea from January 2017 to June 2017. The procedures included craniectomy, craniotomy, cranioplasty, burr hole, and ventriculoperitoneal shunt. Univariate and multivariate logistic regression analyses were performed.

Results: Of the 1576 cases included, 30 showed infection, for an overall SSI rate of 1.9%. Organ/space infection was the most common, found in 21 out of the 30 cases (70%). Staphylococcus aureus was the most common (41%) of all bacteria, and Serratia marcescens (12%) was the most common among gram-negative bacteria. In univariate analyses, the p-values for age, preoperative hospital stay duration, and over T-hour were <0.2. In a multivariate analysis of these variables, only preoperative hospital stay was significantly associated with the incidence of SSI (p<0.001), whereas age and over T-hour showed a tendency to increase the risk of SSI (p=0.09 and 0.06).

Conclusion: Surveillance systems play important roles in the accurate analysis of SSI. The incidence of SSI after neurosurgical procedures assessed by a national surveillance system was 1.9%. Future studies will provide clinically useful results for SSI when data are accumulated.

Keywords: Incidence; Korea; Neurosurgery; Risk factors; Surgical site infection.