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Surgical site infections with multi-drug resistant organisms in patients undergoing neurosurgery: a retrospective
Yasemin Nadir1, Pinar Kiran2, Hale Turan Ozden1
1Infectious Diseases and Cinical Microbiology Department, Izmir Provincial Health Directorate Izmir University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey.
Background:
Multidrug-resistant organisms (MDROs) are a growing global health threat, contributing to higher morbidity and mortality, particularly for surgical site infections (SSIs). This study investigates the risk factors and outcomes of SSIs caused by MDROs in patients undergoing neurosurgery.
Methods:
This study was a retrospective comparative study which included 202 patients that had SSIs after neurosurgical procedures between 2014 and 2024 in Turkey. Patients were divided into two groups according to results of wound culture: MDRO and non-MDRO groups. Binary logistic regression was used to identify independent risk factors for MDRO-related SSIs.
Results:
The MDRO group (n = 60) had significantly higher all-cause mortality (28.3% vs. 8.5%, p <0.01), ICU admission (81.7% vs. 57%, p = 0.01), and longer hospital stays (30 days vs. 24 days, p = 0.04) compared to the non-MDRO group (n = 142). Emergency surgeries, American Society of Anesthesiologists (ASA) grade ≥3, corticosteroid use and organ/space SSIs were identified as significant risk factors. Logistic regression analysis revealed that only organ/space SSIs were independently associated with MDRO-related SSIs (p <0.01).
Conclusion:
This study highlights the significance of MDRO-related SSIs in neurosurgery by demonstrating worse clinical outcomes, including higher mortality, prolonged hospital stays, and increased ICU admission rates. By identifying key risk factors, it contributes to the management of SSIs and supports the development of targeted prevention and control strategies in neurosurgical settings. These findings underscore the need for enhanced infection control measures and may inform future clinical guidelines and research aimed at reducing the burden of MDRO infections in neurosurgical patients.
Insights
Multidrug-resistant organism (MDRO) surgical site infections (SSIs) in neurosurgery lead to worse outcomes, including higher mortality and longer hospital stays. Organ/space SSIs are a key independent risk factor, necessitating targeted prevention strategies.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Public Health
Background:
- Multidrug-resistant organisms (MDROs) pose a significant global health threat, increasing morbidity and mortality.
- Surgical site infections (SSIs) are a major concern in neurosurgery, often complicated by MDROs.
Purpose of the Study:
- To investigate the risk factors and clinical outcomes of SSIs caused by MDROs in neurosurgical patients.
- To identify independent predictors of MDRO-related SSIs in this population.
Main Methods:
- A retrospective comparative study of 202 neurosurgical patients with SSIs between 2014 and 2024 in Turkey.
- Patients were categorized into MDRO and non-MDRO groups based on wound culture results.
- Binary logistic regression analysis was employed to determine independent risk factors.
Main Results:
- The MDRO group (n=60) exhibited significantly higher all-cause mortality (28.3% vs. 8.5%), ICU admission (81.7% vs. 57%), and longer hospital stays (30 vs. 24 days) compared to the non-MDRO group (n=142).
- Significant risk factors included emergency surgeries, ASA grade ≥3, corticosteroid use, and organ/space SSIs.
- Logistic regression identified organ/space SSIs as the sole independent predictor of MDRO-related SSIs (p<0.01).
Conclusions:
- MDRO-related SSIs in neurosurgery are associated with substantially worse clinical outcomes.
- Organ/space SSIs are a critical independent risk factor, highlighting the need for focused prevention.
- Findings support enhanced infection control measures and inform guidelines to reduce MDRO burden in neurosurgical patients.
