Neurosurgical Site Infection Prevention: Single Institute Experience

To estimate the effect of a multimodal prevention program on controlling surgical site infection (SSI) risk among neurosurgical patients.

This prospective study was conducted among adult patients who have undergone neurosurgical procedures in a tertiary-care university-affiliated hospital during January 2008 to December 2013 since the implementation of an infection control program. SSI cases among inpatients were identified by daily active searches, whereas post-discharge surveillance was performed for outpatients through telephone contact 30-35 days after surgery, according to the definition proposed by the Center for Disease Control. The variation of SSI rate during the study period was analyzed by Cochran-Armitage trend test.

Overall, a total of 3042 patients were enrolled and 112 SSI cases were identified during the studied period. SSI more likely occurred in patients with older age (t=5.16, p < 0.01), undergoing emergency operations (x2=50.5, p < 0.01), having higher American Society of Anesthesiologists (ASA) scores (x2=7.2, p=0.01) and clean contaminated wound or above (x2=53.8, p < 0.01). The annual incidence rate of SSI was 6.21%, 5.01%, 3.89%, 3.06%, 2.38% and 2.28%, respectively, showing a significant decreasing trend (z=3.96, p < 0.01).

The results provide evidence of a significant decreasing trend in the SSI rate following the infection prevention program, demonstrating the role of multimodal approach in controlling SSI.