Risk factors for pediatric surgical site infection following neurosurgical procedures for hydrocephalus: a retrospective single-center cohort study.
Risk factors for pediatric surgical site infection following neurosurgical procedures for hydrocephalus: a retrospective single-center cohort study.
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DOI：
10.1186/s12871-021-01342-5
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发表时间：
2021-04-21
影响因子：
2.2
通讯作者：
Yuki K
中科院分区：
文献类型：
--
作者：
Shibamura-Fujiogi M;Ormsby J;Breibart M;Warf B;Priebe GP;Soriano SG;Sandora TJ;Yuki K
感染是脑积水脑脊液分流术后的主要并发症。然而，儿科手术部位感染(SSI)的危险因素目前还没有很好的定义。由于SSI预防捆绑包越来越多地被引入，本研究的目的是评估与单一第四医院儿科医院SSI捆绑后的脑脊液分流手术后SSI相关的危险因素。我们对2017-2019年接受脑脊液分流手术的患者进行了一项回顾性队列研究。通过持续监测，前瞻性地确定了SSI。我们进行了未经调整的Logistic回归分析和单变量分析，以确定SSI与患者人口统计学、合并症和围手术期因素之间的关联，以确定SSI的独立危险因素。我们确定了558例脑脊液分流手术，总体SSI发生率为3.4%。分流术、脑室外引流(EVD)和内窥镜第三脑室造口术(ETV)的SSI发生率分别为4.3%、6.9%和0%。在32 2例分流手术中，围手术期预防性应用克林霉素和心脏疾病与SSI显著相关(前者为4.99，95%C.I.1.27~19.70，p = 为0.0 2；后者为7.19，95%C.I.1.35~38.35，p = 为0.0 2)。在72例EVD手术中未发现SSI的危险因素。我们认为接受克林霉素是围手术期的预防措施，心脏疾病的存在是分流手术中SSI的危险因素。建议将头孢唑林作为围手术期预防的标准抗生素。了解到未经证实的β-内酰胺类过敏标签是一个重大的医学问题，应努力澄清β-内酰胺类过敏状态，以最大限度地增加在分流手术前可以接受头孢唑林预防的患者数量。需要进一步的研究来阐明心脏疾病可能增加分流术后SSI风险的机制。
Infection is a major complication following cerebral spinal fluid (CSF) diversion procedures for hydrocephalus. However, pediatric risk factors for surgical site infection (SSI) are currently not well defined. Because a SSI prevention bundle is increasingly introduced, the purpose of this study was to evaluate risk factors associated with SSIs following CSF diversion surgeries following a SSI bundle at a single quaternary care pediatric hospital. We performed a retrospective cohort study of patients undergoing CSF diversion procedures from 2017 to 2019. SSIs were identified prospectively through continuous surveillance. We performed unadjusted logistic regression analyses and univariate analyses to determine an association between SSIs and patient demographics, comorbidities and perioperative factors to identify independent risk factors for SSI. We identified a total of 558 CSF diversion procedures with an overall SSI rate of 3.4%. The SSI rates for shunt, external ventricular drain (EVD) placement, and endoscopic third ventriculostomy (ETV) were 4.3, 6.9 and 0%, respectively. Among 323 shunt operations, receipt of clindamycin as perioperative prophylaxis and presence of cardiac disease were significantly associated with SSI (O.R. 4.99, 95% C.I. 1.27–19.70, p = 0.02 for the former, and O.R. 7.19, 95% C.I. 1.35–38.35, p = 0.02 for the latter). No risk factors for SSI were identified among 72 EVD procedures. We identified receipt of clindamycin as perioperative prophylaxis and the presence of cardiac disease as risk factors for SSI in shunt procedures. Cefazolin is recommended as a standard antibiotic for perioperative prophylaxis. Knowing that unsubstantiated beta-lactam allergy label is a significant medical problem, efforts should be made to clarify beta-lactam allergy status to maximize the number of patients who can receive cefazolin for prophylaxis before shunt placement. Further research is needed to elucidate the mechanism by which cardiac disease may increase SSI risk after shunt procedures.
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影响因子：
14.2
作者：
Bruinsma, N;Stobberingh, EE;Gavilanes, DAWD
通讯作者：
Gavilanes, DAWD
影响因子：
1.9
作者：
Riva-Cambrin, Jay;Kestle, John R. W.;Simon, Tamara D.
通讯作者：
Simon, Tamara D.
影响因子：
0.7
作者：
PIATT, JH;CARLSON, CV
通讯作者：
CARLSON, CV
DOI：
10.1016/j.jss.2020.10.015
发表时间：
2021-03
期刊：
The Journal of surgical research
影响因子：
--
作者：
Shibamura-Fujiogi M;Ormsby J;Breibart M;Zalieckas J;Sandora TJ;Priebe GP;Yuki K
通讯作者：
Yuki K
影响因子：
0.7
作者：
Davis, SE;Levy, ML;Masri-Lavine, L
通讯作者：
Masri-Lavine, L