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Risk Factors for Infections Related to Lumbar Drainage in Spontaneous Subarachnoid Hemorrhage

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Abstract

Background

A solid knowledge associated with lumbar drainage (LD)-related infections in spontaneous subarachnoid hemorrhage (SAH) patients is necessary and that would be useful in taking effective measures to cope with this complication. We aimed to describe incidence rates and risk factors associated with LD-related infections in SAH patients.

Methods

A retrospective review was performed on SAH patients who underwent LD between July 2010 and August 2015. Patient charts were reviewed to retrieve demographic, clinical, and laboratory data. LD-related infections were defined based on culture results of cerebrospinal fluid in combination with clinical symptoms. Infection rates were calculated, and a logistic regression model was developed to identify risk factors.

Results

A total of 629 SAH patients (25–82 years age range, 42.8 % male) were treated with LD in the period. LD-related infections were identified in 36 patients (5.7 %). Longer duration of LD (≥4 days: p = 0.0037) and puncture site leakage (p < 0.0001) appeared to be risk factors for infection. The infection rate increased with length of the hospital stay (16–20 days: p = 0.0032; ≥21 days: p = 0.0007). 84.6 % of the isolated bacteria were Gram-positive, and the most commonly associated pathogens were Methicillin-resistant coagulase-negative Staphylococcus (MRCNS, 61.5 %).

Conclusions

The patients with LD for more than 4 days or with puncture site leakage had more risk of infection. Infected patients were more likely to stay longer in the hospital. MRCNS were identified as the most frequent causal pathogens. And the use of antibiotics during LD did not appear to reduce the risk of infection.

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Acknowledgments

We would like to thank all the patients who were involved in this study and the staff of First Affiliated Hospital of Harbin Medical University. This study was supported by Grants from the National Natural Science Foundation of China (No. 81501050, 81571108), Natural Science Foundation of Heilongjiang Province (QC2014C104).

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    Authors and Affiliations

    1. Key Laboratory of Neurosurgery, College of Heilongjiang Province, First Affiliated Hospital of Harbin Medical University, Harbin, P.R. China

      Hongsheng Liang, Liyang Zhang, Yonghua Li, Zhenfeng Jiang, Bin Shao & Xiangtong Zhang

    2. School of Life Science, Northeast Agricultural University, Harbin, P.R. China

      Aili Gao

    3. Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P.R. China

      Fulan Hu

    4. Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, P.R. China

      Yan Liu

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    1. Hongsheng Liang
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    Correspondence to Yan Liu or Xiangtong Zhang.

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    The authors declare that they have no conflict of interest.

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    Clinical Medical Ethics Committee of the First Affiliated Hospital of Harbin Medical University approved this research activity.

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    Hongsheng Liang and Liyang Zhang contributed equally to this work.

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    Liang, H., Zhang, L., Gao, A. et al. Risk Factors for Infections Related to Lumbar Drainage in Spontaneous Subarachnoid Hemorrhage. Neurocrit Care 25, 243–249 (2016). https://doi.org/10.1007/s12028-015-0239-1

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