Remote Infections Raise Risk for Surgical Site Infection

TOPLINE: 

Remote infections during hospital stays were associated with an increased risk for surgical site infections in intracranial neurosurgery procedures. 

METHODOLOGY:

• Surgical site infections during neurosurgery procedures are associated with increased morbidity and mortality, as well as increased rates of reoperation, intensive care admission, and prolonged hospitalisation.
• This retrospective single-center register study explored the possible factors associated with surgical site infections among patients undergoing intracranial neurosurgery procedures performed at a university hospital between March 2015 and June 2016.
• The study analysed medical records of 800 neurosurgical patients (median age, 61 years; 50.6% men) to screen for the occurrence of surgical site infections within 30 days post-surgery, or up to 1 year for those with implants.
• Infections were classified by their depth: Superficial (involving the skin or subcutaneous tissue), deep (subgaleal empyema, epidural empyema, or bone flap osteomyelitis), organ (subdural empyema or cerebral abscess), or space (meningitis).

TAKEAWAY:

• Surgical site infections occurred in 6.9% of cases, with nearly half arising from tumour resection (49.1%).
• The median time from surgical procedure to infection was 18 days; space infections such as meningitis appeared earlier, whereas deep infections took longer (P = .004).
• Remote infections during the hospital stay were significantly associated with an increased risk for surgical site infections (odds ratio, 2.02; P = .031), whereas body mass index, insulin therapy, and neurosurgical procedures during the follow-up period were not significantly associated with surgical site infections.
• Staphylococcus aureus (39.5%) and Cutibacterium acnes (27.1%) were the most frequently identified bacteria in surgical site infections.

IN PRACTICE:

“In clinical context, considerations are recommended for neurosurgical patients with ongoing remote infections during their hospital stay. Further perioperative studies are needed in the field of surgical infection prevention,” the authors wrote.

SOURCE:

The lead and corresponding author was Ida-Linnea Böregård, RN, CNOR, MSc, PhD student, Karolinska Institutet, Stockholm, Sweden. The study was published online on March 7, 2025, in the Journal of Hospital Infection.

LIMITATIONS: 

The study’s quasi-experimental design may have introduced systematic bias due to variations in case mix between operating rooms. Moreover, well-known risk factors such as hypothermia, malnutrition, and abnormal glucose levels were not explored due to lack of documentation.

DISCLOSURES: 

The study was supported by internal funding. No relevant conflicts of interest were disclosed by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.