title: Hardware-related infections after deep brain stimulation surgery: review of incidence, severity and management in 212 single-center procedures in the first year after implantation.
abstract: BACKGROUND
  Device-related infection is a common occurrence after deep brain stimulation (DBS) surgery, and may result in additional interventions and a loss of efficacy of therapy. This retrospective review aimed to evaluate the incidence, severity and management of device-related infections in 212 DBS procedures performed in our institute.
  
  
  METHODS
  Data on 106 patients, in whom 212 DBS procedures were performed between 2001 and 2011 at our institute by a single neurosurgeon (M.P.), were reviewed to assess the incidence, severity, management and clinical characteristics of infections in the first year after the implantation of a DBS system.
  
  
  RESULTS
  Infections occurred in 8.5% of patients and 4.2% of procedures. Of the nine infections, eight involved the neurostimulator and extensions, and one the whole system. The infections occurred 30.7 days after implantation: 7 within 30 days and 2 within 6 months. Infected and uninfected patients were comparable in terms of age, sex, indication for DBS implantation and neurostimulator location. In eight cases, the system components involved were removed and re-implanted after 3 months, while in one case the complete hardware was removed and not re-implanted.
  
  
  CONCLUSIONS
  The overall incidence of postoperative infections after DBS system implantation was 4.2%; this rate decreased over time. All infections required further surgery. Correct and timely management of partial infections may result in successful salvage of part of the system.
authors.affiliation: Department of Neurosurgery, San Bortolo Hospital, Vicenza, Italy. massimo.piacentino@ulssvicenza.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Piacentino
authors.forename: Manuela
authors.initials: M
authors.lastname: Pilleri
authors.forename: Luigi
authors.initials: L
authors.lastname: Bartolomei
mesh_terms: D000368:Aged; D020806:Central Nervous System Bacterial Infections / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D046690:Deep Brain Stimulation / Q000009:adverse effects* / Q000379:methods; D004567:Electrodes, Implanted / Q000009:adverse effects*; D004866:Equipment Contamination / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome