title: Risk Factors for Infections Related to Lumbar Drainage in Spontaneous Subarachnoid Hemorrhage.
abstract: A solid knowledge associated with lumbar drainage (LD)-related infections in spontaneous subarachnoid hemorrhage (SAH) patients is necessary and that would be useful in taking effective measures to cope with this complication. We aimed to describe incidence rates and risk factors associated with LD-related infections in SAH patients.
  
  
  
  A retrospective review was performed on SAH patients who underwent LD between July 2010 and August 2015. Patient charts were reviewed to retrieve demographic, clinical, and laboratory data. LD-related infections were defined based on culture results of cerebrospinal fluid in combination with clinical symptoms. Infection rates were calculated, and a logistic regression model was developed to identify risk factors.
  
  
  
  A total of 629 SAH patients (25-82 years age range, 42.8 % male) were treated with LD in the period. LD-related infections were identified in 36 patients (5.7 %). Longer duration of LD (≥4 days: p = 0.0037) and puncture site leakage (p < 0.0001) appeared to be risk factors for infection. The infection rate increased with length of the hospital stay (16-20 days: p = 0.0032; ≥21 days: p = 0.0007). 84.6 % of the isolated bacteria were Gram-positive, and the most commonly associated pathogens were Methicillin-resistant coagulase-negative Staphylococcus (MRCNS, 61.5 %).
  
  
  
  The patients with LD for more than 4 days or with puncture site leakage had more risk of infection. Infected patients were more likely to stay longer in the hospital. MRCNS were identified as the most frequent causal pathogens. And the use of antibiotics during LD did not appear to reduce the risk of infection.
authors.affiliation: Key Laboratory of Neurosurgery, College of Heilongjiang Province, First Affiliated Hospital of Harbin Medical University, Harbin, P.R. China.
authors.forename: Hongsheng
authors.initials: H
authors.lastname: Liang
authors.affiliation: Key Laboratory of Neurosurgery, College of Heilongjiang Province, First Affiliated Hospital of Harbin Medical University, Harbin, P.R. China.
authors.forename: Liyang
authors.initials: L
authors.lastname: Zhang
authors.affiliation: School of Life Science, Northeast Agricultural University, Harbin, P.R. China.
authors.forename: Aili
authors.initials: A
authors.lastname: Gao
authors.affiliation: Key Laboratory of Neurosurgery, College of Heilongjiang Province, First Affiliated Hospital of Harbin Medical University, Harbin, P.R. China.
authors.forename: Yonghua
authors.initials: Y
authors.lastname: Li
authors.affiliation: Key Laboratory of Neurosurgery, College of Heilongjiang Province, First Affiliated Hospital of Harbin Medical University, Harbin, P.R. China.
authors.forename: Zhenfeng
authors.initials: Z
authors.lastname: Jiang
authors.affiliation: Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P.R. China.
authors.forename: Fulan
authors.initials: F
authors.lastname: Hu
authors.affiliation: Key Laboratory of Neurosurgery, College of Heilongjiang Province, First Affiliated Hospital of Harbin Medical University, Harbin, P.R. China.
authors.forename: Bin
authors.initials: B
authors.lastname: Shao
authors.affiliation: Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, P.R. China. liuyan@ems.hrbmu.edu.cn.
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Key Laboratory of Neurosurgery, College of Heilongjiang Province, First Affiliated Hospital of Harbin Medical University, Harbin, P.R. China. zgxgtg@sina.com.
authors.forename: Xiangtong
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002555:Cerebrospinal Fluid / Q000382:microbiology*; D003428:Cross Infection / Q000134:cerebrospinal fluid / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013129:Spinal Puncture / Q000009:adverse effects* / Q000706:statistics & numerical data; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology / Q000601:surgery*
keywords: Infections; Lumbar drainage; Risk factors; Spontaneous subarachnoid hemorrhage