Keywords
Infection control
Intensive care unitsuí
incidence
neurosurgery
How to Cite
Abstract
Introduction: Nosocomial infections (NI) pose a real risk to patient recovery, with a significant increase in morbidity and mortality, as well as higher healthcare costs, due to prolonged hospital stays and a high incidence of other subsequent complications. In neurosurgery, the incidence of infectious complications is low, estimated at around 2-3% overall. Materials and methods: A retrospective observational analysis was conducted at the F. Santojanni Acute Care General Hospital, located in the city of Buenos Aires, CABA, in the intensive care unit, over a period of 7 months. Results: Sixty medical records were reviewed, of which 21 were selected because they matched the objectives set. However, 12 patients (57.14%) were infected. Conclusion: It is necessary to improve the practice of healthcare personnel in the management of ICU patients. A study should be conducted on these neurosurgical procedures to prevent risk factors from being as significant as they have been until now.
References
1. Pérez POC, Arbolay OL, Machín MO, Casares MH, Torres GCE. Infecciones y neurocirugía: realidades, desafíos y estrategias de trabajo en el Hospital Hermanos Ameijeiras. Rev Científica Hallazgos21. 2019;4(1):12-23.
2. Dondériz HTC, Acuña MCA, Pérez GP. Infección nosocomial en la unidad de cuidados intensivos del Instituto de Neurología y Neurocirugía de Ciudad de La Habana, Cuba. 2007;8.
3. Savitz SI. The ethics of prophylactic antibiotics for neurosurgical procedures. J Med Ethics. 2002;28(6):358-63.
4. Dashti SR, Baharvahdat H, Spetzler RF, Sauvageau E, Chang SW, Stiefel MF, et al. Operative intracranial infection following craniotomy. Neurosurg Focus. 2008;24(6):E10.
5. Augello Díaz SL, Hernández González K, Salomón Vila A. Infecciones nosocomiales en el postoperatorio neuroquirúrgico. Correo Científico Méd. 2015;19(3):453-64.
6. Martínez Checa J, Planes Martínez J, González de la Flor P, Fernández Sierra MA, Jiménez Romano E, Cordero Moreno A. Incidencia y factores de riesgo de infección nosocomial de herida quirúrgica en neurocirugía. Neurocirugía. 2000;11(2):103-9.
7. Figueiredo EG, Balasso GT, Teixeira MJ. Infecções em pós-craniotomias: revisão literária. Arq Bras Neurocir Braz Neurosurg. 2012;31(4):219-23.
8. Kurdyumova NV, Ershova ON, Savin IA, Shifrin MA, Danilov GV, Aleksandrova IA, et al. Drainage-associated meningitis in neurocritical care patients: results of a five-year prospective study. Vopr Neirokhir Im NN Burdenko. 2017;81(6):56.
9. Altamirano IZ, Carrasco AM, Orellana ISA, Crespo DO, Paredes MG, Vela VR, et al. Infección por bacterias multirresistentes en pacientes con trauma craneoencefálico del servicio de terapia intensiva del Hospital Luis Vernaza, Ecuador. 2020. Disponible en: https://zenodo.org/record/4404758
10. Liang W, Yuan-Run Z, Min Y. Clinical presentations and outcomes of postoperative central nervous system infection caused by multidrug-resistant/extensively drug-resistant Acinetobacter baumannii: a retrospective study. Surg Infect (Larchmt). 2019;20(6):460-4.
11. Saleh T, Kamau E, Rathe JA. New and old lessons from a devastating case of neonatal E coli meningitis. BMC Pediatrics 2024;24. https://doi.org/10.1186/s12887-024-04787-y.
12. Aly A, Pettorini B. COVID-19 lockdown presented a chance to evaluate emergency referrals to paediatric neurosurgical unit: a prospective cohort study. Child’s Nervous System 2021;37:729–32. https://doi.org/10.1007/s00381-020-04985-w.
13. Anestis DM, Tsitsopoulos PP, Foroglou NG, Tsatali MS, Marinos K, Theologou M, et al. Cross-Cultural Adaptation and Validation of the Greek Version of the “Full Outline of Unresponsiveness Score”: A Prospective Observational Clinimetric Study in Neurosurgical Patients. Neurocritical Care 2022;36:584–94. https://doi.org/10.1007/s12028-021-01342-w.
14. Archibald LK, Ritter A, Kalyatanda G. Central Nervous System Infections. vol. 1, 2024, p. 461–551. https://doi.org/10.1007/978-3-031-62220-5_31.
15. Ata F, Sharma R, Ibrahim WH, Kartha AB. Pulmonary Tuberculosis with Central Nervous System Streptococcus anginosus Coinfection in an Immunocompetent Man. Infectious Diseases in Clinical Practice 2021;29:E250–3. https://doi.org/10.1097/IPC.0000000000000961.
16. Chang H, Nyquist P. Infection Management in the Neurocritical Care Setting. Hot Topics in Acute Care Surgery and Trauma, vol. Part F4667, 2024, p. 429–38. https://doi.org/10.1007/978-3-031-50117-3_26.
17. Cheng L, Cai Q. Construction and verification of prediction model for postoperative central nervous system infection in patients with severe neurological diseases. Chinese Journal of Neurosurgery 2023;39:594–600. https://doi.org/10.3760/cma.j.cn112050-20220516-00254.
18. Choi YK, Kim H-J, Ahn J, Ryu J-A. Impact of early nutrition and feeding route on clinical outcomes of neurocritically ill patients. PLOS ONE 2023;18. https://doi.org/10.1371/journal.pone.0283593.
19. D’Agostino R, Kursinskis A, Parikh P, Letarte P, Harmon L, Semon G. Management of Penetrating Traumatic Brain Injury: Operative versus Non-Operative Intervention. Journal of Surgical Research 2021;257:101–6. https://doi.org/10.1016/j.jss.2020.07.046.
20. Di Ieva A, Stewart C, Suero-Molina E. Large Language Models in Neurosurgery. Advances in Experimental Medicine and Biology, vol. 1462, 2024, p. 177–98. https://doi.org/10.1007/978-3-031-64892-2_11.
21. Di W, Bingsha H, Riukang W, Jiao L, Yanru L, Feng F. Clinical application of metagenomic next-generation sequencing in central nervous system infection of critically ill patients from Neurosurgery. Chinese Journal of Neuromedicine 2022;21:47–53. https://doi.org/10.3760/cma.j.cn115354-20211118-00749.
22. Dvalishvili A, Khinikadze M, Gegia G, Khutsishvili L. Neuroendoscopic lavage versus traditional surgical methods for the early management of posthemorrhagic hydrocephalus in neonates. Child’s Nervous System 2022;38:1897–902. https://doi.org/10.1007/s00381-022-05606-4.
23. Florian IA, Lupan I, Sur L, Gabriel G, Timiş TL. To be, or not to be… Guillain-Barré Syndrome. Autoimmunity Reviews 2021;20. https://doi.org/10.1016/j.autrev.2021.102983.
24. Goethe EA, LoPresti M, Bertot B, Lam S. Cerebellitis as a neurosurgical disease in pediatrics. Journal of Clinical Neuroscience 2021;85:57–63. https://doi.org/10.1016/j.jocn.2020.12.019.
25. Joshua AM, Pai R. Infections of the Central Nervous System, 2022, p. 603–20. https://doi.org/10.1007/978-981-19-0209-3_10.
26. Khanal B, Singh SK, Mishra R, Kafle P, Sharma MR. Pediatric Intensive Care Unit in a Developing Nation: Exploring Acute Neurological Illnesses and Their Clinical Course. Journal of Institute of Medicine Nepal 2023;45:45–8. https://doi.org/10.59779/jiomnepal.1283.
27. Koester SW, Catapano JS, Lawton MT. In Reply to the Letter to the Editor Regarding “COVID-19 and Neurosurgery Consultation Call Volume at a Single Large Tertiary Center with a Propensity-Adjusted Analysis.” World Neurosurgery 2021;147:222. https://doi.org/10.1016/j.wneu.2020.12.167.
28. Lappay JI, Gaddi MJS, Calotes-Castillo LV. Serratia marcescens Healthcare-Associated Ventriculitis and Cerebral Abscess in a Neonate with Chiari II Malformation: A Case Report and Systematic Review. Acta Medica Philippina 2022;56:71–6. https://doi.org/10.47895/amp.vi0.829.
29. Li H, Yu W, Wang G, Cai H. Outcome of Using Intraventricular Plus Intravenous Polymyxin B in Post-neurosurgical Patients With Multi/Extensively Drug-Resistant Gram-Negative Bacteria-Induced Intracranial Infection. Frontiers in Medicine 2022;9. https://doi.org/10.3389/fmed.2022.913364.
30. López-Amor L, García-Prieto E, Fernández-Suárez J, Escudero-Augusto D, Vàzquez F, Fernández J. Evaluation of a commercial multiplex PCR for diagnosis of central nervous system (CNS) nosocomial infections. Journal of Microbiological Methods 2020;171. https://doi.org/10.1016/j.mimet.2020.105865.
31. Magrini E, Rando E, del Giacomo P, Matteini E, Leanza GM, Sanmartin F, et al. Cerebrospinal fluid drain infection caused by pandrug-resistant Staphylococcus epidermidis successfully treated with ceftaroline in combination with fosfomycin and vancomycin. Diagnostic Microbiology and Infectious Disease 2024;109. https://doi.org/10.1016/j.diagmicrobio.2024.116205.
32. Mokhtar MN, Azaharuddin I, Abdullah FH, Izaham A, Abdul Rahman R. A rare case of Pseudomonas putida ventriculitis in intensive care unit: A case report. Frontiers in Medicine 2022;9. https://doi.org/10.3389/fmed.2022.1058121.
33. Naz A, Rasheed G, Baig MS, Baqi S. Characteristics and Outcome of Patients with Traumatic Brain Injury in the Intensive Care Unit of a Public Sector Hospital in Karachi, Pakistan. Journal of the Dow University of Health Sciences 2022;15:122–9. https://doi.org/10.36570/jduhs.2021.3.1187.
34. Pandey S, Yao P, Qian Z, Ji T, Wang K, Gao L. Case series; Ceftazidime/avibactam for treating post-neurosurgical ventriculitis and meningitis due to Carbapenem-resistant Klebsiella pneumonia (CRKP). Interdisciplinary Neurosurgery: Advanced Techniques and Case Management 2023;34. https://doi.org/10.1016/j.inat.2023.101832.
35. Pandit AS, Palasz J, Nachev P, Toma AK. Mechanical Complications of External Ventricular and Lumbar Drains. World Neurosurgery 2022;166:e140–54. https://doi.org/10.1016/j.wneu.2022.06.127.
36. Piastra M, Caresta E, Massimi L, Picconi E, Luca E, Morena TC, et al. Lipid Peroxidation and Antioxidant Consumption as Early Markers of Neurosurgery-Related Brain Injury in Children. Neurocritical Care 2020;33:124–31. https://doi.org/10.1007/s12028-019-00870-w.
37. Prust ML, Mbonde A, Rubinos C, Shrestha GS, Komolafe M, Saylor D, et al. Providing Neurocritical Care in Resource-Limited Settings: Challenges and Opportunities. Neurocritical Care 2022;37:583–92. https://doi.org/10.1007/s12028-022-01568-2.
38. Raksin PB. Acute Care Neurosurgery by Case Management: Pearls and Pitfalls. 2022. https://doi.org/10.1007/978-3-030-99512-6.
39. Rezzonico LF, Peracchi F, Vecchi M, Bassi G, Merli M, Bana NB, et al. Meropenem–Vaborbactam for the Treatment of Post-Neurosurgical Meningitis Caused by KPC Producer Klebsiella Pneumoniae: A Case Report and Review of the Literature. Antibiotics 2024;13. https://doi.org/10.3390/antibiotics13040331.
40. Ribeiro B, Bishop P, Jalili S. When a Stroke is not Just a Stroke: Escherichia coli Meningitis with Ventriculitis and Vasculitis: A Case Report. Journal of Critical Care Medicine 2020;6:65–70. https://doi.org/10.2478/jccm-2020-0002.
41. Rocco CD, Pang D, Rutka JT. Textbook of Pediatric Neurosurgery. 2020. https://doi.org/10.1007/978-3-319-72168-2.
42. Segal N, Polcz VE, McKean JA, Kariyawasam V, Carson JS, Fahy BG. Pseudomonal Meningoencephalitis with Ventriculitis Secondary to Bacteremia in a Burn Patient: A Novel Case. Journal of Burn Care and Research 2021;42:832–5. https://doi.org/10.1093/jbcr/irab016.
43. Stephani C, Choi AHK, Möerer O. Point-of-care detection of lactate in cerebrospinal fluid. Intensive Care Medicine Experimental 2021;9. https://doi.org/10.1186/s40635-021-00385-9.
44. Tian Y, Duan Y, Gao R, Gao W, Xu S, Wang S, et al. DIAGNOSTIC PERFORMANCE OF CENTRAL NERVOUS SYSTEM INFECTIONS IN PATIENTS WITH NEUROSURGICAL INTENSIVE CARE USING METAGENOMIC NEXT-GENERATION SEQUENCING: A PROSPECTIVE OBSERVATIONAL STUDY. Shock 2024;61:375–81. https://doi.org/10.1097/SHK.0000000000002320.
45. Volpicelli L, Cairoli S, Al Ismail D, Baisi F, Sacco F, Goffredo BM, et al. Simultaneous post-neurosurgical ventriculitis and bacteraemia by two different strains of KPC-producing K. pneumoniae successfully treated with meropenem/vaborbactam and high dose of fosfomycin. Journal of Global Antimicrobial Resistance 2024;37:86–90. https://doi.org/10.1016/j.jgar.2024.03.003.
46. Walek KW, Leary OP, Sastry R, Asaad WF, Walsh JM, Mermel L. Decreasing External Ventricular Drain Infection Rates in the Neurocritical Care Unit: 12-Year Longitudinal Experience at a Single Institution. World Neurosurgery 2021;150:e89–101. https://doi.org/10.1016/j.wneu.2021.02.087.
47. Zhou Q, Wang H, Zhan T, Yang X, Wen L. Successful treatment of ventriculitis caused by mdr/xdr gram-negative bacillus using ceftazidime/avibactam: Case series and literature review. Infection and Drug Resistance 2021;14:1691–701. https://doi.org/10.2147/IDR.S306222.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 José Roberto Pella Junior, Sandra Arcieri (Author)