Abstract
The optimal surgical and antimicrobial treatment for intracranial infections after neurosurgery is unknown. We investigated the clinical, laboratory, and microbiological characteristics of intracranial infections after neurosurgery. In addition, treatment outcome in patients treated according to a standardized algorithm was evaluated. Consecutive patients with extradural, intradural, and device-related infections after cranial neurosurgery were included prospectively. A standardized antimicrobial and surgical treatment regimen was applied. The probability of infection-free survival was estimated by using the Kaplan-Meier survival method. Survival curves between groups were compared by using log-rank Mantel-Cox test. Of 103 infections, 58 (56%) were extradural, 33 (32%) intradural, and 12 (12%) device-associated. Foreign material was involved in 98 infections (95%), including 78 bone flaps or fixation devices, 41 duraplasties, 17 external drains, and 15 functional devices. The median duration from primary surgery until infection diagnosis was 33 days (range, 6-1132 days). In total, 69 infections (67%) were monomicrobial, 26 (25%) polymicrobial, and 8 (8%) culture-negative. Ninety of 103 patients (90%) underwent surgical interven...Continue Reading
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