Central nervous system infections in post-neurosurgical patients. Intensive Care Unit, Hospital de Clínicas Dr. Manuel Quintela, Uruguay, 2020-2024
Abstract
Post-neurosurgical infections occur in patients undergoing invasive neurosurgical procedures. In Uruguay, they represent 46% of complications. This observational, analytical, and retrospective study, conducted in the Intensive Care Unit of the Dr. Manuel Quintela Hospital de Clínicas from 2020 to 2024, sought to characterize central nervous system infections, with an emphasis on meningitis and ventriculitis.
The objectives were to determine their frequency, identify the most commonly associated type of intervention, the microorganisms involved, the characteristics of the cerebrospinal fluid, and identify factors predisposing to the development of infection and associated mortality. To this end, a review of electronic medical records authorized through informed or surrogate consent was conducted.
Of a total of 236 patients undergoing neurosurgery, 31 were considered for infection. Analysis of clinical, fluid characteristics, and cultures revealed that 21 were confirmed and 10 were probable. Eighty percent were male, and 58% were due to trauma. Gram-positive cocci predominated. Male sex and length of monitoring were associated with infection, while length of monitoring and vascular disease were associated with mortality. Some of the results were biased by population characteristics (especially etiology) and sample size. This is the first study in our unit to analyze this group of patients. The data obtained will inform clinical decisions.
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