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Published on: January 6, 2011
Surgical site infections after deep brain stimulation surgery: frequency, characteristics and management in a 10-year
Silje Bjerknes1, Inger Marie Skogseid1, Terje Sæhle2
1Department of Neurology, Oslo University Hospital, Oslo, Norway.
Background/Aims:
Deep brain stimulation (DBS) implant infection is a feared complication, as it is difficult to manage and leads to increased patient morbidity. We wanted to assess the frequency and possible risk factors of DBS related infections at our centre. In the purpose of evaluating treatment options, we also analyzed treatment, and the clinical and microbiological characteristics of the infections.
Methods:
Electronic medical records of all patients undergoing DBS surgery at our centre, from 2001 through 2010, were retrospectively reviewed.
Results:
Of the 588 procedures performed 33 (5.6%) led to an infection. Some patients underwent several procedures, thus 32 out of totally 368 patients (8.7%), and 19 out of 285 patients (6.7%) who received primary lead implantation, developed an infection. Most infections (52%) developed within the first month and 79% within three months. In the majority of the infections (79%) hardware removal was performed. Staphylococcus aureus infections were the most frequent (36%), and more likely to have earlier onset, pus formation, a more aggressive development and lead to hardware removal. No risk factors were identified.
Conclusions:
Our results indicate that infections with more severe symptoms and growth of staphylococcus aureus should be treated with local hardware removal and antibiotic therapy. In other infections, an initial trial of antibiotic treatment could be considered. New knowledge about the microbiology of DBS related infections may lead to more effective antimicrobial treatment.
Insights
Deep brain stimulation (DBS) implant infections occurred in 5.6% of procedures, with Staphylococcus aureus being the most common. Early hardware removal and antibiotics are recommended for severe cases.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Medical Device Technology
Background:
- Deep brain stimulation (DBS) implant infections are a significant concern, leading to increased patient morbidity.
- Effective management strategies for DBS infections are crucial due to their complexity.
Purpose of the Study:
- To determine the frequency and potential risk factors of DBS-related infections.
- To analyze treatment approaches, and clinical and microbiological characteristics of these infections.
Main Methods:
- Retrospective review of electronic medical records for all patients undergoing DBS surgery between 2001 and 2010.
- Analysis of infection rates, timing, causative agents, and treatment outcomes.
Main Results:
- An overall infection rate of 5.6% (33/588 procedures) was observed.
- Staphylococcus aureus was the most frequent pathogen (36%), often associated with earlier onset and more severe symptoms.
- Most infections (79%) required hardware removal, and no specific risk factors were identified.
Conclusions:
- Infections caused by Staphylococcus aureus or presenting with severe symptoms warrant local hardware removal and antibiotic therapy.
- Initial antibiotic treatment may be considered for less severe infections.
- Understanding DBS infection microbiology can guide more effective antimicrobial strategies.
