Follow-up Study on the Effect of Risk-Stratified, Protocol-Based Perioperative Antibiotic Prophylaxis on Postoperative Infections in a Tertiary Care Neurosurgical Department over 10 Years (2007–2016)
Objective To study the effectiveness of risk-stratified prophylactic antibiotic policy on meningitis, surgical site, and extraneurosurgical site infections among postoperative neurosurgical patients from the year 2007 to 2016. This is a follow-up study for a similar analysis done from 1994 to 2006,...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical Publishers, Inc.
2018-03-01
|
| Series: | Indian Journal of Neurosurgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1649331 |
| _version_ | 1828431775403081728 |
|---|---|
| author | Ashutosh Agarwal Sachin A. Borkar Arti Kapil Jyotsna Dabral Ashish Suri Shashank S. Kale Ashok K. Mahapatra |
| author_facet | Ashutosh Agarwal Sachin A. Borkar Arti Kapil Jyotsna Dabral Ashish Suri Shashank S. Kale Ashok K. Mahapatra |
| author_sort | Ashutosh Agarwal |
| collection | DOAJ |
| description | Objective To study the effectiveness of risk-stratified prophylactic antibiotic policy on meningitis, surgical site, and extraneurosurgical site infections among postoperative neurosurgical patients from the year 2007 to 2016. This is a follow-up study for a similar analysis done from 1994 to 2006, which is published in Neurosurgery.
Methods Retrospective audit of 30,251 consecutive neurosurgical cases from January 2007 through December 2016 at a tertiary care center with culture positivity in samples taken from patients showing clinical/radiologic evidence of infection as an objective marker of postoperative infection. Risk-stratified, variable-duration antibiotic prophylaxis policy was followed over 10 years; it was modified in the year 2014, and infections from 2007 to 2013 were compared with 2014 to 2016.
Results Over 10 years, there were 2,782 infections in 2,193 (9.45%) patients with meningitis in 281 (0.96%), bloodstream infections in 596 (2.05%), respiratory infections in 913 (3.11%), urinary tract infections (UTIs) in 697 (2.30%), and wound infections in 295 (1.02%) patients. On comparison, the proportion of infections between 2014 and 2016 was significantly lower than that between 2007 and 2013 (4.61 ± 0.14% vs. 11.52 ± 2.2%, p = 0.001). The most common microorganisms were non–lactose-fermenting gram-negative bacilli, followed by Klebsiella and Escherichia coli. The proportion of gram-positive cocci (GPC) was 16.2% with methicillin-resistant Staphylococcus aureus (MRSA) accounting for 5.5% cases.
Conclusion A risk-stratified, variable-duration prophylactic antibiotic protocol helps in reducing postoperative meningitis, surgical site, and extraneurosurgical site infections in neurosurgical patients, and prophylaxis with first-generation cephalosporin and aminoglycoside is effective. |
| first_indexed | 2024-12-10T18:09:20Z |
| format | Article |
| id | doaj.art-d312208c8b554b25bc0cd32e174424f5 |
| institution | Directory Open Access Journal |
| issn | 2277-954X 2277-9167 |
| language | English |
| last_indexed | 2024-12-10T18:09:20Z |
| publishDate | 2018-03-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Indian Journal of Neurosurgery |
| spelling | doaj.art-d312208c8b554b25bc0cd32e174424f52022-12-22T01:38:32ZengThieme Medical Publishers, Inc.Indian Journal of Neurosurgery2277-954X2277-91672018-03-01070102903510.1055/s-0038-1649331Follow-up Study on the Effect of Risk-Stratified, Protocol-Based Perioperative Antibiotic Prophylaxis on Postoperative Infections in a Tertiary Care Neurosurgical Department over 10 Years (2007–2016)Ashutosh Agarwal0Sachin A. Borkar1Arti Kapil2Jyotsna Dabral3Ashish Suri4Shashank S. Kale5Ashok K. Mahapatra6Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Neurosurgery, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Microbiology, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Neurosurgery, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Neurosurgery, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Neurosurgery, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Neurosurgery, All India Institute of Medical Sciences, New Delhi, IndiaObjective To study the effectiveness of risk-stratified prophylactic antibiotic policy on meningitis, surgical site, and extraneurosurgical site infections among postoperative neurosurgical patients from the year 2007 to 2016. This is a follow-up study for a similar analysis done from 1994 to 2006, which is published in Neurosurgery. Methods Retrospective audit of 30,251 consecutive neurosurgical cases from January 2007 through December 2016 at a tertiary care center with culture positivity in samples taken from patients showing clinical/radiologic evidence of infection as an objective marker of postoperative infection. Risk-stratified, variable-duration antibiotic prophylaxis policy was followed over 10 years; it was modified in the year 2014, and infections from 2007 to 2013 were compared with 2014 to 2016. Results Over 10 years, there were 2,782 infections in 2,193 (9.45%) patients with meningitis in 281 (0.96%), bloodstream infections in 596 (2.05%), respiratory infections in 913 (3.11%), urinary tract infections (UTIs) in 697 (2.30%), and wound infections in 295 (1.02%) patients. On comparison, the proportion of infections between 2014 and 2016 was significantly lower than that between 2007 and 2013 (4.61 ± 0.14% vs. 11.52 ± 2.2%, p = 0.001). The most common microorganisms were non–lactose-fermenting gram-negative bacilli, followed by Klebsiella and Escherichia coli. The proportion of gram-positive cocci (GPC) was 16.2% with methicillin-resistant Staphylococcus aureus (MRSA) accounting for 5.5% cases. Conclusion A risk-stratified, variable-duration prophylactic antibiotic protocol helps in reducing postoperative meningitis, surgical site, and extraneurosurgical site infections in neurosurgical patients, and prophylaxis with first-generation cephalosporin and aminoglycoside is effective.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1649331antibiotic prophylaxismeningitiswound infection |
| spellingShingle | Ashutosh Agarwal Sachin A. Borkar Arti Kapil Jyotsna Dabral Ashish Suri Shashank S. Kale Ashok K. Mahapatra Follow-up Study on the Effect of Risk-Stratified, Protocol-Based Perioperative Antibiotic Prophylaxis on Postoperative Infections in a Tertiary Care Neurosurgical Department over 10 Years (2007–2016) Indian Journal of Neurosurgery antibiotic prophylaxis meningitis wound infection |
| title | Follow-up Study on the Effect of Risk-Stratified, Protocol-Based Perioperative Antibiotic Prophylaxis on Postoperative Infections in a Tertiary Care Neurosurgical Department over 10 Years (2007–2016) |
| title_full | Follow-up Study on the Effect of Risk-Stratified, Protocol-Based Perioperative Antibiotic Prophylaxis on Postoperative Infections in a Tertiary Care Neurosurgical Department over 10 Years (2007–2016) |
| title_fullStr | Follow-up Study on the Effect of Risk-Stratified, Protocol-Based Perioperative Antibiotic Prophylaxis on Postoperative Infections in a Tertiary Care Neurosurgical Department over 10 Years (2007–2016) |
| title_full_unstemmed | Follow-up Study on the Effect of Risk-Stratified, Protocol-Based Perioperative Antibiotic Prophylaxis on Postoperative Infections in a Tertiary Care Neurosurgical Department over 10 Years (2007–2016) |
| title_short | Follow-up Study on the Effect of Risk-Stratified, Protocol-Based Perioperative Antibiotic Prophylaxis on Postoperative Infections in a Tertiary Care Neurosurgical Department over 10 Years (2007–2016) |
| title_sort | follow up study on the effect of risk stratified protocol based perioperative antibiotic prophylaxis on postoperative infections in a tertiary care neurosurgical department over 10 years 2007 2016 |
| topic | antibiotic prophylaxis meningitis wound infection |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1649331 |
| work_keys_str_mv | AT ashutoshagarwal followupstudyontheeffectofriskstratifiedprotocolbasedperioperativeantibioticprophylaxisonpostoperativeinfectionsinatertiarycareneurosurgicaldepartmentover10years20072016 AT sachinaborkar followupstudyontheeffectofriskstratifiedprotocolbasedperioperativeantibioticprophylaxisonpostoperativeinfectionsinatertiarycareneurosurgicaldepartmentover10years20072016 AT artikapil followupstudyontheeffectofriskstratifiedprotocolbasedperioperativeantibioticprophylaxisonpostoperativeinfectionsinatertiarycareneurosurgicaldepartmentover10years20072016 AT jyotsnadabral followupstudyontheeffectofriskstratifiedprotocolbasedperioperativeantibioticprophylaxisonpostoperativeinfectionsinatertiarycareneurosurgicaldepartmentover10years20072016 AT ashishsuri followupstudyontheeffectofriskstratifiedprotocolbasedperioperativeantibioticprophylaxisonpostoperativeinfectionsinatertiarycareneurosurgicaldepartmentover10years20072016 AT shashankskale followupstudyontheeffectofriskstratifiedprotocolbasedperioperativeantibioticprophylaxisonpostoperativeinfectionsinatertiarycareneurosurgicaldepartmentover10years20072016 AT ashokkmahapatra followupstudyontheeffectofriskstratifiedprotocolbasedperioperativeantibioticprophylaxisonpostoperativeinfectionsinatertiarycareneurosurgicaldepartmentover10years20072016 |