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SAMJ: South African Medical Journal

On-line version ISSN 2078-5135
Print version ISSN 0256-9574

Abstract

BOKOP FOTSO, C et al. Postoperative infections: Aetiology, incidence and risk factors among neurosurgical patients in Mthatha, South Africa. SAMJ, S. Afr. med. j. [online]. 2020, vol.110, n.5, pp.403-408. ISSN 2078-5135.  http://dx.doi.org/10.7196/SAMJ.2020.v110i5.13779.

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.

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