title: Sacral Neuromodulator InterStim Surgical Site Infection: Two Case Reports.
abstract: OBJECTIVE
  : The surgical site infection rate of sacral neuromodulator placement for the treatment of refractory urge urinary incontinence is reported to be between 5% and 7.9%. Our objective was to report the investigation process of these infections and a possible source for their occurrence.
  
  
  METHODS
  : We performed infection control surveillance of two patients that underwent sacral neuromodulator placement on the same date, in the same operating room, and by the same staff who developed similar sacral cellulitis postoperatively.
  
  
  RESULTS
  : The investigation revealed Staphylococcus aureus infections with a common antibiogram in both patients. Nasal cultures of all personnel involved in their care, showed Staphylococcus aureus with the same antibiogram only in a Medtronic representative who had manipulated the InterStim settings. Genetic analysis showed this to be an identical strain in one patient infection.
  
  
  CONCLUSIONS
  : The postoperative manipulation of device settings may be a source of surgical site infection, and infection control practices including strict hand washing, gloves, gown and mask may be warranted.
authors.affiliation: From the *Division of Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Mount Sinai School of Medicine; †Department of Obstetrics and Gynecology, Lenox Hill Hospital, New York, NY; and ‡Englewood Hospital Infection Control Committee, Englewood, NJ.
authors.forename: Azin
authors.initials: A
authors.lastname: Shahryarinejad
authors.forename: Michael D
authors.initials: MD
authors.lastname: Vardy
authors.forename: Gilad
authors.initials: G
authors.lastname: Filmar
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Walter
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Kocher