Analysis of nosocomial infections and evaluation of pre-surgical prophylaxis in a neurological reference center

Abstract

Background: Post-operative and intrahospital infections generate greater morbidity and mortality and increase the costs of care. The abuse of antibiotics and the increasing prevalence of postoperative infections by gram-negative bacteria have led to the use of alternative regimens of antimicrobial prophylaxis. Objectives: To describe the behavior of nosocomial infections and compare two schemes of pre-surgical antimicrobial prophylaxis. Material and methods: Retrospective study, in which the rates of nosocomial infections are described, and their relationship with two schemes of pre-surgical prophylaxis (PEP) from March to June; EPP 1 (year 2017) and EPP2 (year 2018), as well as with additional measures to the PPE as use of chloraprep / Lysol (2017) and hand washing (2018) during these periods, in order to evaluate the effectiveness of the same. Results: The number of episodes of infections per 100 discharges was 10.67 (2017) and 11.42 (2018) without statistical differences. The infection rate of central venous catheter was 17.4 vs 9.1 (p = 0.001), urosepsis of 10.75 vs 9.27 (p = 0.03,) and bacteraemia of 2.59 to 1.88 (p = 0.04,). During the EPP1 scheme there were 125 episodes of infection, while EPP2, only 119, as well as decrease in urosepsis, bacteremia and infection of the gastrostomy site. Conclusions: There was no significant increase in neurosurgical infections with both schemes, nor in nosocomial infections. It is important to mention that the use of chloraprep for presurgical asepsis and Lysol for decontamination of inert surfaces, as well as the improvement in handwashing techniques have been determinant for the control of nosocomial infections.