Postoperative Infections Of CNS: A Retrospective Study

Objective: To study the risk factors and spectrum of neurosurgical postoperative intracranial infection.Materials and Methods: Totally 5405 patients who had a neurosurgical operation from Jan. 1996 to Dec. 2003 in General Hospitai, Tianjin Medical University were chosen (172 cases with intracranial infection). Many risk factors were studied retrospectively, including sex, age, the operation duration, the season, the preoperative diseases, open or closed craniocerebral injuries, having diabetes mellitus before the operation, preoperative application of hormones and antibiotics, the approach, having CSF fistulae, the insertion of drainage tube ( with the exception of ventricle drainage), postoperative application of antibiotics. A date-base was set up with EXCEL, and Logistic regression was selected to analysis the factors with may cause infection.Results: the analysis of 5405 cases ( male 3099, female 2306, mean age 48.23 ?7.38) revealed that infection rate was closely related to the operation durations, CSF fistulae, ventricle drainage, the insertion of tubes, the approach of the post fossa, the complication from DM, open craniocerebral injuries. While had little effect on sex, age, the season, longer application of hormones before the operation, preoperative diseases, and longer application of antibiotics before( 1 day ) or after the operation.Conclusions: Neurosurgical postoperative intracranial infection was related to many factors. To decrease its incidence, in clinical experiences, the operation should be finished as soon as possible, the suture should be done completely to prevent CSF fistulae, and the duration of the ventricle drainage should be controlled strictly. Moreover, because of the preoperative application of the third generation Cephalosporin and Quinolone agents to prevent infection, the infection rate of G" bacteria was decreasing gradually, and that of G+ bacteria (MRSA/MRSE mostly)was increasing.