Single-center Retrospective Study Of Etiological Characteristics And Risk Factors Of Intracranial Infection After Craniotomy For Intracranial Tumors

Objective:Analysis of our hospital patients with intracranial tumor risk factors of intracranial infection occurred after craniotomy and pathogen characteristics,and determine our surgical operation excision of intracranial tumor in patients with intracranial infection risks,to provide some reference for our college hospital infection prevention and control,and make corresponding prevention measures.Methods:The case data of 652 patients in a single neurosurgery group(the same surgeon)who underwent intracranial tumor surgery and met the inclusion and exclusion criteria from January 2018 to December 2020 were retrospectively analyzed.The occurrence of intracranial infection and the distribution characteristics of pathogens were mainly analyzed by descriptive analysis,and the risk factors of PCII were analyzed by univariate analysis and binary logistic regression analysis.Results:A total of 652 patients underwent intracranial tumor surgery from 2018 to 2020,and the incidence of intracranial infection was 9.0%.The incidence of intracranial infection in each year was 7.9%,7.0%and 11.9%.The reasons for the different infection rates from 2018 to 2020 were related to the different rates of hypoproteinemia,subatentorial surgery and malignant tumor(P<0.05).In 2018,Gram positive bacteria(G+)were the main pathogens of intracranial infection(75%),and in 2019,G+(50%)and Gram-negative bacteria(G-)were equally distributed.In 2020,G-(53.8%)dominated.The proportion of Gram-negative bacteria gradually increased from 2018 to 2020.In the distribution of pathogenic bacteria in 2020,acinetobacter baumannii dominated.Single factor analysis showed that occurs in patients with intracranial infection after surgery compared with no patients with intracranial infection occurs,the sex,operation times(≥2 times),operation time(>4 h),surgical blood loss(≥1000 ml),intraoperative blood transfusion,postoperative cerebrospinal fluid leakage,postoperative intraventricular external drainage tube differences statistically significant(P<0.05).Multivariate logistic regression analysis showed that the number of operations(≥2),operation time(>4h),operation blood loss(≥1000ml),intraoperative blood transfusion,postoperative cerebrospinal fluid leakage and postoperative indplacement of external ventricular drainage tube were risk factors for intracranial infection(OR>1,P<0.05).Patients with surgery duration>4 hours had 1.278 times higher risk of infection.Patients with≥2 operations had a 5.459 times higher risk of infection.Patients with blood loss≥1000ml during surgery had a 3.426 times higher risk of infection.Patients with intraoperative transfusion had a 2.484 times higher risk of infection.The risk of infection was 8.755 times higher in patients with intraventricular drainage tube.Patients with postoperative cerebrospinal fluid leakage had a 15.415 times higher risk of infection.The OR value of postoperative cerebrospinal fluid leakage is the largest,which has the greatest influence on intracranial infection.Conclusion:The infection rate of PCII in single group of neurosurgery department in our hospital was 9.0%from 2018 to 2020,and Acinetobacter baumannii gradually became the main pathogenic bacteria.Operation times(≥2),operation time(>4 h),postoperative blood loss(≥1000ml),intraoperative blood transfusion,postoperative cerebrospinal fluid leakage,and postoperative indplacement of external ventricular drainage tube are the risk factors for intracranial infection after craniotomy in patients with intracranial tumor in our hospital,among which postoperative cerebrospinal fluid leakage has the greatest impact,and prevention should be targeted at the above risk factors.