P232: Prospective surveillance of intracranial infection in neurosurgical intensive care unit

Abstract

IntroductionIntracranial infection (ICI) is a dangerous complicationfor neurosurgical patients at the intensive care unit(ICU). A comprehensive information about the infectionrates and risk factors is not available.ObjectivesThe prospective study was conducted to establish theICI rates and risk factors for patients at Neuro-ICU.MethodsAll the data on patients staying in Neuro-ICU for morethan 48 hours in 2010 - 2012 (30 months) was dailyentered into a database. These data included the use ofmechanical ventilation, intravascular devices, externalventricular/lumbar drains, urinary catheters, Levin tubesetc. The presence of intracranial, respiratory, blood andurinary infections was con sidered based on the CDCDefinitions of Nosocomial Infections (2008). All thedata were analyzed statistically.ResultsThe collected data for a total of 777 ICU patients withneurosurgical pathology were saved in the electronicdatabase .Patients with ICI (109 pers.) showed the same distri-bution of the main neurosurgical pathology (p = 0.7)and gender structure (p = 0.08) as the group of othercases. The differences were found in patients  age (aver-age 35.2 years and 42.1 years respectively, p = 0.0003).The ICI rate was 14% ± 1,2% (CI 11.65% - 16.35%). Inthis group of patients bloodstream infections occurredsignificantly more often (p = 0.002), as well as respira-tory (p = 0.035) and urinary tract infections (p <0.000)were more common. Significant differences wereobserved in the use of external ventricular drainage (p<0.000). No differences were seen in the use of intracra-nial pressure monitoring (26.6% in the studied groupversus 20.1%). The presence of ICI significantly pro-longed the length of stay in ICU (an average of 38.9days versus 18.1 days, p <0.000) and increased mortality(p = 0.008).ConclusionNeurosurgical patients with i ntracranial infection staylonger in ICU, they show more frequent manifestationof other sites infections, and are at greater risk of death.Among the risk factors for intracranial infection a morefrequent use of external ventricula r drainage is signifi-cantly notable.Disclosure of interestNone declared.