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Postoperative infections: Aetiology, incidence and risk factors among neurosurgical patients in Mthatha, South Africa

C Bokop Fotso, D T Abaver, D Muballe, S Vasaikar, T Apalata

Abstract


Background. Despite progress in hospital care, infections continue to represent one of the major complications among hospitalised patients.

Objectives. To determine the aetiology and incidence of hospital-acquired infections and their associated risk factors following neurosurgical procedures.

Methods. A retrospective study was conducted from October 2013 to September 2014. Data including demographics, hospitalisation period, type of operation and primary diagnosis were collected. Post-surgical infections were confirmed microbiologically. SPSS (Statistical Package for the Social Sciences) version 23 was used for statistical analysis.

Results. Among a total of 1 688 patients who underwent neurosurgical operations, the incidence of post-surgical infections was 4.2% per year. Post-surgical infections were significantly associated with craniotomy (p<0.0001), prolonged stay in hospital (≥30 days) (p=0.008), and patient age ≥35 years (p=0.05). Staphylococcus aureus was the most frequently isolated pathogen (19.7%), followed by Klebsiella pneumoniae (12.7%). A total of 42.9% of S. aureus isolates were methicillin-resistant S. aureus (MRSA), but all these isolates were susceptible to vancomycin; 44.4% of K. pneumoniae isolates were extended-spectrum beta-lactamase (ESBL)-positive, but were susceptible to carbapenems, piperacillin-tazobactam and amikacin.

Conclusions. Post-surgical infections remain an important problem in neurosurgery. Increased resistance to causative pathogens is a major concern.

 


Authors' affiliations

C Bokop Fotso, Division of Medical Microbiology, Department of Laboratory Medicine and Pathology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa

D T Abaver, Division of Medical Microbiology, Department of Laboratory Medicine and Pathology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa

D Muballe, Department of Neurosurgery, Nelson Mandela Academic Complex and Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa

S Vasaikar, Division of Medical Microbiology, Department of Laboratory Medicine and Pathology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa; National Health Laboratory Service, Mthatha, South Africa

T Apalata, Division of Medical Microbiology, Department of Laboratory Medicine and Pathology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa; National Health Laboratory Service, Mthatha, South Africa

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Keywords

Neurosurgery; Post-surgical infections; Risk factors; Causative agents; Resistance patterns

Cite this article

South African Medical Journal 2020;110(5):403-408. DOI:10.7196/SAMJ.2020.v110i5.13779

Article History

Date submitted: 2020-04-29
Date published: 2020-04-29

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