title: Surgical site infections after deep brain stimulation surgery: frequency, characteristics and management in a 10-year period.
abstract: OBJECTIVE
  Deep brain stimulation (DBS) implant infection is a feared complication, as it is difficult to manage and leads to increased patient morbidity. We wanted to assess the frequency and possible risk factors of DBS related infections at our centre. In the purpose of evaluating treatment options, we also analyzed treatment, and the clinical and microbiological characteristics of the infections.
  
  
  METHODS
  Electronic medical records of all patients undergoing DBS surgery at our centre, from 2001 through 2010, were retrospectively reviewed.
  
  
  RESULTS
  Of the 588 procedures performed 33 (5.6%) led to an infection. Some patients underwent several procedures, thus 32 out of totally 368 patients (8.7%), and 19 out of 285 patients (6.7%) who received primary lead implantation, developed an infection. Most infections (52%) developed within the first month and 79% within three months. In the majority of the infections (79%) hardware removal was performed. Staphylococcus aureus infections were the most frequent (36%), and more likely to have earlier onset, pus formation, a more aggressive development and lead to hardware removal. No risk factors were identified.
  
  
  CONCLUSIONS
  Our results indicate that infections with more severe symptoms and growth of staphylococcus aureus should be treated with local hardware removal and antibiotic therapy. In other infections, an initial trial of antibiotic treatment could be considered. New knowledge about the microbiology of DBS related infections may lead to more effective antimicrobial treatment.
authors.affiliation: Department of Neurology, Oslo University Hospital, Oslo, Norway.
authors.forename: Silje
authors.initials: S
authors.lastname: Bjerknes
authors.affiliation: Department of Neurology, Oslo University Hospital, Oslo, Norway.
authors.forename: Inger Marie
authors.initials: IM
authors.lastname: Skogseid
authors.affiliation: Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.
authors.forename: Terje
authors.initials: T
authors.lastname: Sæhle
authors.affiliation: Department of Neurology, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Espen
authors.initials: E
authors.lastname: Dietrichs
authors.affiliation: Department of Neurology, Oslo University Hospital, Oslo, Norway.
authors.forename: Mathias
authors.initials: M
authors.lastname: Toft
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D046690:Deep Brain Stimulation / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult