Acta Neurochirurgica

, Volume 141, Issue 12, pp 1303–1308

Nosocomial Infections in a Neurosurgery Intensive Care Unit

  • M. Dettenkofer
  • W. Ebner
  • F. -J. Hans
  • D. Forster
  • R. Babikir
  • J. Zentner
  • K. Pelz
  • F. D. Daschner

DOI: 10.1007/s007010050434

Cite this article as:
Dettenkofer, M., Ebner, W., Hans, FJ. et al. Acta Neurochir (Wien) (1999) 141: 1303. doi:10.1007/s007010050434

Summary

¶ In order to identify overall and site-specific nosocomial infection (NI) rates in patients receiving neurosurgical intensive care therapy, a prospective study was started in February 1997 in the eight-bed neurosurgical ICU of the University Hospital of Freiburg, Germany. Case records were reviewed twice a week, all microbiology reports were reviewed and ward staff was consulted. NI were defined according to the CDC-criteria and were categorised into specific infection sites. Within 20 months, 545 patients with a total of 5,117 patient days were investigated (mean length of stay: 9.4 days). 113 NI were identified in 90 patients (72 pts. with one, 13 with two and 5 with three infections, respectively). A moderate to high overall incidence (20.7/100 pts.) and a moderate incidence density (22.1/1,000 patient days) of NI in the neurosurgical ICU could be documented; these figures are well within the range of published data. Site specific incidence rates and incidence densities were: 1 bloodstream infection per 100 patients (0.9 central line-associated BSIs per 1,000 central line-days), 9 pneumonias per 100 patients (15.1 ventilator-associated pneumonias per 1,000 ventilator-days), 7.3 urinary tract infections per 100 patients (8.5 urinary catheter-associated UTIs per 1,000 urinary catheter-days). Additionally, 1.1 cases of meningitis, 0.7 brain abscesses/ventriculitis, and 1.7 other infections (surgical site infection, bronchitis, catheter related local infection, diarrhoea) were documented per 100 patients, respectively. 14.6% of isolated pathogens were E. coli, 10.2% enterococci, 9.6% S. aureus, 6.4% CNS, 6.4% Klebsiella spp., 5% Enterobacter spp. and 5% Pseudomonas spp.. In 11 cases of NI no pathogen could be isolated.

Keywords: Intensive care unit; neurosurgery; nosocomial infection; surveillance. 

Copyright information

© Springer-Verlag Wien 1999

Authors and Affiliations

  • M. Dettenkofer
    • 1
  • W. Ebner
    • 1
  • F. -J. Hans
    • 2
  • D. Forster
    • 1
  • R. Babikir
    • 1
  • J. Zentner
    • 2
  • K. Pelz
    • 3
  • F. D. Daschner
    • 1
  1. 1.Institute of Environmental Medicine and Hospital Epidemiology, University Hospital Freiburg, Freiburg, GermanyDE
  2. 2.Department of Neurosurgery, University Hospital Freiburg, Freiburg, GermanyDE
  3. 3.Institute of Medical Microbiology, University Hospital Freiburg, Freiburg, GermanyDE

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