Factors of infection associated with DBS hardware

Ref:Abode-Iyamah KO,et al.J Neurosurg.
 2018 Mar 9:1-10doi: 10.3171/2017.9.JNS1780(Epub ahead of print)deep brain electrical stimulation (DBS) is an effective way to treat certain neurological and mental illnessesInfections associated with DBS hardware can cause serious complications, with the literature reporting that DBS-related infection rates are as high as 23%At present, the main risk factors and feasible preventive measures leading to infection remain uncertainThe results of the study by Kingsley OAbode-Iyamah of the School of Public Health at the University of Iowa in Iowa were published online in The March 2018 issue of J.Neurosurgthe study included DBS implanted patients operated by a surgeon (J.D.W.G.) at the University of Iowa Hospital and Clinic between December 2005 and September 2015, all of whom were adults who received DBS implants for the first time and were 18 years of ageExclude those who have made electrode adjustments or stimulate generator changersCollect data on the patient's demographics, clinical symptom characteristics, surgical procedures, and surgical site infections (surgical site, SSI) As required by the National Health Safety Network (NHSN), the risk factors associated with DBS-related infections and the efficacy of the preventive use of vancomycin powder (VP) in wounds were analyzed for 90 days and 1 year after DBS implantation a total of 242 adult patients underwent 245 DBS operations in , placing 464 electrodes, most of whom received double-sided electrode implants Of the 245 operations, 9 (3.7%) were infected within 90 days of DBS placement, and 16 (6.5%) wounds were infected within 1 year of surgery The most common SSI pathogen is Gram-positive bacteria There was no difference between clinical manifestations and surgical conditions in patients with infection and non-infected patients (Table 1) table 1 Comparison of cases of infection at the surgical site with the conditionofing of non-infected patients The incidence of SSI was 3.3% in patients who used VP prophylactic treatment on incisions during surgery (OR-0.32; 95% CI, 0.10-1.02; P-0.04); After controlling the patient's gender, the correlation between VP and reduced SSI risk did not meet the predetermined significant target (adjusting OR to 0.32; 95% CI, 0.10-1.03; P-0.06) The incidence of DBS phased implantation and Phase I implantation is similar to that of SSI in patients with Phase I implantation the authors note that the results suggest that clinical characteristics and surgical-related factors are not related to the risk of SSI, but that VP use during surgery may help reduce SSI risk DBS surgery still has a high incidence of SSI after 90 days, follow-up continued for more than 1 year, and is beneficial for controlling DBS-related infections (
Xuan compiled, Professor Wang Zhiqiu of Huashan Hospital affiliated with Fudan University, editor-in-chief of "Outside Information" and editor-in-chief of Fudan University's affiliated Huashan Hospital
Professor Chen Guancheng ) relevant links